Evaluation of local invasion by oesophageal carcinoma
a
prospective study of prone computed tomography scanning
J Waymana, S Chakravertyb, S M Griffina, G J Doyleb, M J Keirc, W Simpsonb
a Royal
Victoria Infirmary, Newcastle upon Tyne, UK: Northern Oesophago-Gastric
Cancer Unit, b Department of Radiology, c Department
of Medical Physics
Correspondence to: and requests for reprints to: Professor S Michael Griffin, Northern Oesophago-Gastric Cancer Unit, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK S.M.Griffin{at}ncl.ac.uk
Submitted 30 November
1999;
Accepted 6 June 2000
The aim of this study was to assess the value of prone computed
tomography compared with the traditional supine position, in the
assessment of invasion of adjacent mediastinal structures by
oesophageal cancer. A prospective, single blind case-case comparative study of signs of local tumour invasion was conducted. Sixty nine consecutive patients undergoing computed tomography for preoperative staging of oesophageal carcinoma were studied. Computed tomography scanning of the thorax was performed in the standard supine followed by
prone position; in 39 patients the computed tomography findings were correlated with the surgical findings. Four established
radiological signs used to assess mediastinal invasion were scored in
each case.
Based on the radiological scoring system, there was a significant
down staging in the probability of aortic invasion in 12 of the 69 cases (p<0.05). A similar improvement in accuracy was seen in the
cases undergoing surgery; of the 38 cases who did not have aortic
invasion at operation, 10 cases were scored as high for aortic invasion
on the supine scans compared with only three on the prone position
(p<0.05). Prone scanning was not of significant additional value in
the assessment of major airway or pericardial invasion.
Modification of the computed tomography protocol to include scanning in
the prone position will improve the accuracy of the preoperative
staging of patients with oesophageal malignancy and reduce the chance
of overstaging disease. Especially in centres where endoscopic
ultrasound is not available, our modification may reduce the chance of
denying patients potentially curative operations.
Keywords: computed tomography; neoplasm staging; oesophageal neoplasm; local invasion
© 2001 by The Fellowship of Postgraduate Medicine
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Oesophageal cancer
-
Screening (oncology)
-
Radiology (diagnostics)
-
Surgical oncology
-
Clinical diagnostic tests
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
