Diagnostic Performance of Diffusion-weighted Magnetic Resonance Imaging in Assessing Lymph Node Metastasis of Esophageal Cancer Compared with PET

Overview

Journal Esophagus

Publisher Springer

Specialties Gastroenterology
Oncology

Date 2019 Dec 11

PMID 31820208

Citations 12

Authors

Kiyohiko Shuto

Tsuguaki Kono

Toru Shiratori

Yasunori Akutsu

Masaya Uesato

Mikito Mori

Kazuo Narushima

Shunsuke Imanishi

Yoshihiro Nabeya

Noriyuki Yanagawa

Shinichi Okazumi

Keiji Koda

Hisahiro Matsubara

Affiliations

Soon will be listed here.

Abstract

Background: Although diffusion-weighted magnetic resonance imaging (DWI) for detecting lymph node (LN) metastasis is reported to be a successful modality for primary malignant tumors, there are few studies relating to esophageal cancer. This study aimed to clarify the diagnostic performance of DWI for assessing LN metastasis compared with positron emission tomography (PET) in patients with esophageal squamous cell cancer (eSCC).

Methods: Seventy-six patients with histologically proven eSCC who underwent curative esophagectomy without neoadjuvant treatment were reviewed retrospectively. Harvested LNs were divided into 1229 node stations with 94 metastases. Diagnostic abilities and prognostic significance were compared.

Results: In a station-by-station evaluation, the sensitivity was higher in DWI than PET (67% vs. 32%, P < 0.001). DWI showed more than 80% sensitivity for middle- and large-sized cancer nests and large area of cancer nests. The DWI-N0 group had a better 5-year relapse-free survival rate than the DWI-N+ group (78.5% vs. 34.2%, P < 0.001), as did the PET-N0 group. DWI-N status was an independent prognostic factor (hazard ratio [HR], 2.642; P = 0.048), as was PET-N status (HR 2.481; P = 0.033).

Conclusions: DWI, which depends on cancer cell volume followed by elevated intranodal density, is a non-invasive modality and showed higher sensitivity than PET. It has clinical impact in predicting postoperative survival for patients with eSCC alongside its diagnostic ability and has significant performance in clinical practice.

Citing Articles

Value of Computed Tomography Scan for Detecting Lymph Node Metastasis in Early Esophageal Squamous Cell Carcinoma.

Zeng Y, Liu Y, Li J, Feng B, Lu J Ann Surg Oncol. 2024; 32(3):1635-1650.

PMID: 39586955 DOI: 10.1245/s10434-024-16568-z.

Diffusion-Weighted Magnetic Resonance Imaging for the Diagnosis of Lymph Node Metastasis in Patients with Biliary Tract Cancer.

Murakami T, Shimizu H, Nojima H, Shuto K, Usui A, Kosugi C Cancers (Basel). 2024; 16(18).

PMID: 39335116 PMC: 11430223. DOI: 10.3390/cancers16183143.

Preoperative dual-energy computed tomography and positron-emission tomography evaluation of lymph node metastasis in esophageal squamous cell carcinoma.

Sun X, Niwa T, Kazama T, Okazaki T, Koyanagi K, Kumaki N PLoS One. 2024; 19(9):e0309653.

PMID: 39302928 PMC: 11414887. DOI: 10.1371/journal.pone.0309653.

Radiomics diagnostic performance for predicting lymph node metastasis in esophageal cancer: a systematic review and meta-analysis.

Ma D, Zhou T, Chen J, Chen J BMC Med Imaging. 2024; 24(1):144.

PMID: 38867143 PMC: 11170881. DOI: 10.1186/s12880-024-01278-5.

Radiomics-clinical nomogram for preoperative lymph node metastasis prediction in esophageal carcinoma.

Geng X, Zhang Y, Li Y, Cai Y, Liu J, Geng T Br J Radiol. 2024; 97(1155):652-659.

PMID: 38268475 PMC: 11027331. DOI: 10.1093/bjr/tqae009.

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