CT prediction of irresectability in esophageal carcinoma: value of additional patient positions and relation to patient outcome

To improve computed tomographic (CT) prediction of local irresectability and to correlate preoperative CT findings with patient outcome. Eighty-five patients with esophageal carcinoma underwent CT in supine, left lateral decubitus, and prone positions. CT signs that were indicative of local irresect...

Full description

Saved in:
Bibliographic Details
Published in:Abdominal imaging 1997-03, Vol.22 (2), p.132-137
Main Authors: van den Hoed, R D, Feldberg, M A, van Leeuwen, M S, van Dalen, T, Obertop, H, Kooyman, C D, van der Schouw, Y T, de Graaf, P W
Format: Article
Language:English
Subjects:
Adenocarcinoma - diagnostic imaging
Adenocarcinoma - mortality
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
Aorta, Thoracic - diagnostic imaging
Carcinoma - diagnostic imaging
Carcinoma - mortality
Carcinoma - surgery
Carcinoma, Squamous Cell - diagnostic imaging
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - surgery
Esophageal Neoplasms - diagnostic imaging
Esophageal Neoplasms - mortality
Esophageal Neoplasms - surgery
Esophagectomy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Invasiveness
Neoplastic Cells, Circulating
Posture - physiology
Survival Rate
Tomography, X-Ray Computed
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To improve computed tomographic (CT) prediction of local irresectability and to correlate preoperative CT findings with patient outcome. Eighty-five patients with esophageal carcinoma underwent CT in supine, left lateral decubitus, and prone positions. CT signs that were indicative of local irresectability included (1) an angle of contact >45 degrees with the aorta; (2) obliteration of triangular fat pad between the tumor, aorta, and spine; (3) tumor contiguous with the aorta in all three positions; and (4) indentation of the airway in all three positions. All CT signs indicative for local irresectability concerning the aorta had comparable percentages of false-positive scans (75%) when correlated with surgical findings. When correlated with pathologic findings, >45 degrees angle of contact with the aorta yielded the fewest false-positive cases (9%). Concerning the airway, additional positions changed the staging correctly in 1 of 18 cases. Median survival was 21 and 8 months, respectively, for tumors considered CT resectable or irresectable. Additional patient positions do not improve the CT prediction of aortic invasion. Predicted resectability correlates with a significant longer life expectancy.
ISSN:0942-8925
1432-0509
DOI:10.1007/s002619900157