EVALUATION OF THE EFFECTIVENESS OF MULTIPARAMETRIC MAGNETIC RESONANCE IMAGRAPHY IN DETERMINING THE T-STAGE OF ESOPHAGAL SQUAMOUS CELL CANCER (PRELIMINARY STUDY)
Abstract
Treatment and survival of patients with locally advanced esophageal cancer have improved significantly in recent decades with the introduction of neoadjuvant and adjuvant therapies. In this regard, the accuracy of determining the depth of tumor tissue invasion (T-stage) is critical for choosing treatment tactics. Magnetic resonance imaging (MRI), with its high contrast resolution, can potentially be the method of choice in assessing the T stage of esophageal cancer. The purpose of the study is to determine the diagnostic capabilities of MRI in determining the T stage of squamous cell carcinoma of the esophagus. Materials and methods. A total of 62 patients diagnosed with squamous cell carcinoma of the esophagus were examined. All patients included in the study underwent MRI of the esophagus according to the developed protocol, followed by histological verification to determine further treatment tactics. Results. The sensitivity of the MRI method for T-staging was 95.0%, specificity 59.6%, and accuracy up to 78.6%, AUC 0.773, which indicates the high diagnostic capabilities of the method. Conclusion. MRI allows you to accurately determine the T-stage of esophageal cancer (squamous cell type). The inclusion of MRI results in the standard examination of esophageal tumors improves the efficiency of T-stage diagnosis and
diagnostic confidence. Further research on this topic is required to optimize the MRI scanning protocol and introduce the method into clinical practice for suspected esophageal cancer.
References
Amin MB, Greene FL, Edge SB et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population — based to a more “personalized” approach to cancer staging. CA A Cancer J Clinicians. 2017 Mar;67(2):93–9. DOI: 10.3322/caac.21388.
Bunting D, Bracey T, Fox B et al. Loco-regional staging accuracy in oesophageal cancer — How good are we in the modern era? European Journal of Radiology. 2017 Dec;97:71–5. DOI: 10.1016/j.ejrad.2017.10.015.
Giganti F, Ambrosi A, Petrone M. Prospective comparison of MR with diffusion-weighted imaging, endoscopic ultrasound, MDCT and positron emission tomography-CT in the pre-operative staging of oesophageal cancer: results from a pilot study. The British Journal of Radiology. DOI: 10.1259/bjr.20160087.
Guo J, Wang Z, Qin J et al. A prospective analysis of the diagnostic accuracy of 3 T MRI, CT and endoscopic ultrasound for preoperative T staging of potentially resectable esophageal cancer. Cancer Imaging. 2020 Dec;20(1):64. DOI: 10.1186/s40644-020-00343-w.
Jin Z, Chen D, Chen M et al. (Neo)adjuvant Chemoradiotherapy is Beneficial to the Long-term Survival of Locally Advanced Esophageal Squamous Cell Carcinoma: A Network Meta-analysis. World J Surg. 2022 Jan;46(1):136–46. DOI: 10.1007/s00268-021-06301-2.
Kelly S. A systematic review of the staging performance of endoscopic ultrasound in gastro-oesophageal carcinoma. Gut. 2001 Oct 1;49(4):534–9. DOI: 10.1136/gut.49.4.534.
Krill T, Baliss M, Roark R et al. Accuracy of endoscopic ultrasound in esophageal cancer staging. J Thorac Dis. 2019 Aug;11(S12):S1602–9. DOI: 10.21037/jtd.2019.06.50.
Leandri C, Soyer P, Oudjit A et al. Contribution of magnetic resonance imaging to the management of esophageal diseases: A systematic review. European Journal of Radiology. 2019 Nov;120:108684. DOI: 10.1016/j.ejrad.2019.108684.
Lee SL, Yadav P, Starekova J et al. Diagnostic
Performance of MRI for Esophageal Carcinoma: A Systematic Review and Meta-Analysis. Radiology. 2021 Jun;299(3):583–94. DOI: 10.1148/radiol.2021202857.
Mostert B, Van Der Gaast A. Neoadjuvant treatment in esophageal cancer—established treatments and new developments reviewed. Ann Esophagus. 2021 Jun;4:20-20. DOI: 10.21037/aoe-2020-05.
Obermannová R, Alsina M, Cervantes A, Leong T, Lordick F, Nilsson M, et al. Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology. 2022 Oct;33(10):992–1004. DOI: 10.1016/j.annonc.2022.07.003.
Pellat A, Dohan A, Soyer P et al. The Role of Magnetic Resonance Imaging in the Management of Esophageal Cancer. Cancers. 2022 Feb 23;14(5):1141. DOI: 10.3390/cancers14051141.
Riddell AM, Hillier J, Brown G et al. Potential of Surface-Coil MRI for Staging of Esophageal Cancer. American Journal of Roentgenology. 2006 Nov;187(5):1280–7. DOI: 10.2214/AJR.05.0559.
Rice TW, Patil DT, Blackstone EH. 8th edition AJCC/UICC staging of cancers of the esophagus and esophagogastric junction: application to clinical practice. Ann Cardiothorac Surg. 2017 Mar;6(2):119–30. DOI: 10.21037/acs.2017.03.14.
