Share this content in WeChat
Clinical Article
Study on the diagnostic efficacy of combined MRI sequences contrast MDCT in T staging of esophageal squamous cell carcinoma
LIN Shengfa  SU Liqing  PENG Ying  SHEN Yanfu  LI Tian  MA Mingping 

Cite this article as: Lin SF, Su LQ, Peng Y, et al. Study on the diagnostic efficacy of combined MRI sequences contrast MDCT in T staging of esophageal squamous cell carcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(4): 43-48. DOI:10.12015/issn.1674-8034.2022.04.008.

[Abstract] Objective To compare the diagnostic efficacy between combined MRI sequences and multi detector-row computed tomography (MDCT) in T staging of esophageal squamous cell carcinoma, so as to provide a reference basis for clinical accurate T staging.Materials and Methods Ninty patients with esophageal squamous cell carcinoma confirmed by biopsy in our hospital were prospectively collected. All of them had complete combined MRI sequences (high-resolution T2-TSE-BLADE sequence, high-resolution T1-STAR-VIBE-FS delayed enhancement sequence) and MDCT enhancement examination data. The evaluation was performed separately under double-blind by two attending radiologists, and the Kappa consistency test was used to evaluate the consistency of the T staging of the two subjects. The sensitivity, specificity and Yoden index of the above two T-staging methods were calculated according to the gold standard of postoperative pathology; the consistency of combined MRI sequences, single-mode sequence and MDCT staging were analyzed by Kappa consistency test according to the pathological criteria.Results Postoperative pathological T staging: 22 patients (24.44%) in T1 stage, 22 patients (24.44%) in T2 stage, 34 patients (37.78%) in T3 stage and 12 patients (13.33%) in T4a stage. The Kappa values of the consistency test of the two T staging methods for the two subjects were 0.97 and 0.86, respectively. The results of this study: (1) The sensitivity, specificity and Youden index of the combined MRI sequences for T1-T3 stages are higher than those of MDCT; (2) The two staging methods have low sensitivity, high specificity, and low Youden index for T4a; (3) The Kappa values from high to low were combined MRI sequences (0.91), T1-STAR-VIBE-FS (0.81), T2-TSE-BLADE (0.78) and MDCT (0.71).Conclusions Combined MRI sequences are better than MDCT for T staging of esophageal squamous cell carcinoma.
[Keywords] esophageal squamous cell carcinoma;magnetic resonance imaging;multi detector-row computed tomography;T staging;diagnostic efficacy

LIN Shengfa1   SU Liqing2   PENG Ying1   SHEN Yanfu1   LI Tian1   MA Mingping1*  

1 Shengli Clinical Medical College of Fujian Medical University, Department of Radiology of Fujian Provincial Hospital, Fuzhou 350001, China

2 Oncology Clinical Medical College of Fujian Medical University, Department of Radiology of Fujian Cancer Hospital, Fuzhou 350011, China

Ma MP, E-mail:

Conflicts of interest   None.

Received  2022-01-04
Accepted  2022-03-21
DOI: 10.12015/issn.1674-8034.2022.04.008
Cite this article as: Lin SF, Su LQ, Peng Y, et al. Study on the diagnostic efficacy of combined MRI sequences contrast MDCT in T staging of esophageal squamous cell carcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(4): 43-48.DOI:10.12015/issn.1674-8034.2022.04.008

Abnet CC, Arnold M, Wei WQ. Epidemiology of Esophageal Squamous Cell Carcinoma[J]. Gastroenterology, 2018, 154(2): 360-373. DOI: 10.1053/j.gastro.2017.08.023.
Zhang S, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2015[J]. Journal of the National Cancer Center, 2021, 1(1): 2-11. DOI: 10.1016/j.jncc.2020.12.001
Shao Y, Chen D, Ye L, et al. Survival benefit of perioperative chemotherapy for T1-3N0M0 stage esophageal cancer: a SEER database analysis[J]. Thorac Dis, 2021, 13(2): 995-1004. DOI: 10.21037/jtd-20-2877.
Sohda M, Kumakura Y, Saito H, et al. Clinical Significance of Salvage Esophagectomy for Patients with Esophageal Cancer and Factors of Influencing Long-term Survival[J]. Anticancer Res, 2017, 37(9): 5045-5051. DOI: 10.21873/anticanres.11920.
Yang H, Liu H, Chen Y, et al. Neoadjuvant Chemoradiotherapy Followed by Surgery Versus Surgery Alone for Locally Advanced Squamous Cell Carcinoma of the Esophagus (NEOCRTEC5010): A Phase Ⅲ Multicenter, Randomized, Open-Label Clinical Trial[J]. Clin Oncol, 2018, 36(27): 2796-2803. DOI: 10.1200/JCO.2018.79.1483.
Lee SL, Yadav P, Starekova J, et al. Diagnostic Performance of MRI for Esophageal Carcinoma: A Systematic Review and Meta-Analysis[J]. Radiology, 2021, 299(3): 583-594. DOI: 10.1148/radiol.2021202857.
Wang M, Zhu Y, Li Z, et al. Impact of endoscopic ultrasonography on the accuracy of T staging in esophageal cancer and factors associated with its accuracy: A retrospective study[J]. Medicine (Baltimore), 2022, 101(8): 28603. DOI: 10.1097/MD.0000000000028603.
Wang J, Tang L, Lin L, et al. Imaging characteristics of esophageal cancer in multi-slice spiral CT and barium meal radiography and their early diagnostic value[J]. Gastrointest Oncol, 2022, 13(1): 49-55. DOI: 10.21037/jgo-22-36.
Leandri C, Soyer P, Oudjit A, et al. Contribution of magnetic resonance imaging to the management of esophageal diseases: A systematic review[J]. Eur J Radiol, 2019, 120: 1-10. DOI: 10.1016/j.ejrad.2019.108684.
De Cobelli F, Palumbo D, Albarello L, et al. Esophagus and Stomach, Is There a Role for MR Imaging?[J]. Magn Reson Imaging C, 2020, 28: 1-15. DOI: 10.1016/j.mric.2019.08.001.
Xu X, Sun ZY, Wu HW, et al. Diffusion-weighted MRI and 18 F-FDG PET/CT in assessing the response to neoadjuvant chemoradiotherapy in locally advanced esophageal squamous cell carcinoma[J]. Radiat Oncol, 2021, 16(1): 132-140. DOI: 10.1186/s13014-021-01852-z.
Song T, Yao Q, Qu J, et al. The value of intravoxel incoherent motion diffusion-weighted imaging in predicting the pathologic response to neoadjuvant chemotherapy in locally advanced esophageal squamous cell carcinoma[J]. Eur Radiol, 2021, 31(3): 1391-1400. DOI: 10.1007/s00330-020-07248-z.
Cong Q, Li G, Wang Y, et al. DW-MRI for esophageal squamous cell carcinoma, correlations between ADC values with histologic differentiation and VEGF expression: A retrospective study[J]. Oncol Lett, 2019, 17(3): 2770-2776. DOI: 10.3892/ol.2019.9934.
Qu J, Zhang H, Wang Z, et al. Comparison between free -breathing radial VIBE on 3 T MRI and endoscopic ultrasound for preoperative T staging of Resectable oesophageal cancer, with histopathological correlation[J]. Eur Radiol, 2018, 28(2): 780-787. DOI: 10.1007/s00330-017-4963-0.
Riddell AM, Allum WH, Thompson JN, et al. The appearances of oesophageal carcinoma demonstrated on high-resolution, T2-weighted MRI, with histopathological correlation[J]. Eur Radiol, 2007, 17(2): 391-399. DOI: 10.1007/s00330-006-0363-6.
Hou DL, Shi GF, Gao XS, et al. Improved longitudinal length accuracy of gross tumor volume delineation with diffusion weighted magnetic resonance imaging for esophageal squamous cell carcinoma[J]. Radiat Oncol, 2013, 8: 169. DOI: 10.1186/1748-717X-8-169.
Miyawaki Y, Sato H, Oya S, et al. Clinical impact of abdominal versus mediastinal metastases as a prognostic factor for poor outcomes following esophageal cancer surgery: a retrospective study[J]. BMC Cancer, 2021, 21(1): 725-739. DOI: 10.1186/s12885-021-08484-2.
Weng DH. Technical detail of BLADE[J]. Chin J Magn Reson Imaging, 2010, 1(5): 376-379. DOI: 10.3969/j.issn.1674-8034.2010.05.013.
Finkenzeller T, Zorger N, Kuhnel T, et a1. Novel application of T1-weighted BLADE sequences with fat suppression compared to TSE in contrast-enhanced T1-weighted imaging of the neck:cutting-edge images?[J]. Magn Reson Imaging, 2013, 37(3): 660-668. DOI: 10.1002/jmri.23843.
Froehlich JM, Metens T, Chilla B, et a1. Should less motion sensitive T2-weighted BLADE TSE replace Cartesian TSE for female pelvic MRI?[J]. Insights Imaging, 2012, 3(6): 611-618. DOI: 10.1007/s13244-012-0193-9.
Yu N, Yang C, Ma G, et al. Feasibility of pulmonary MRI for nodule detection in comparison to computed tomography[J]. BMC Medical Imaging, 2020, 20(1): 53-59. DOI: 10.1186/s12880-020-00451-w.
Azevedo RM, de Campos RO, Ramalho M, et al. Free-breathing 3D T1-weighted gradient-echo sequence with radial data sampling in abdominal MRI: preliminary observations[J]. Am J Roentgenol, 2011, 197(3): 650-657. DOI: 10.2214/AJR.10.5881.
Chandarana H, Feng L, Block TK, et al. Free-breathing contrast-enhanced multiphase MRI of the liver using a combination of compressed sensing, parallel imaging, and golden-angle radial sampling[J]. Invest Radiol, 2013, 48(1): 10-16. DOI: 10.1097/RLI.0b013e318271869c.
Deng HP, Li XM, Yang L, et al. DCE-MRI of esophageal carcinoma using star-VIBE compared with conventional 3D-VIBE[J]. Sci Rep, 2021, 11(1): 24091-20496. DOI: 10.1038/s41598-021-03171-5.
Zhang FG, Zhang HK, Li X. The values of pre-operative T staging of potentially resectable esophageal cancer: Blade combining with breath-free radial VIBE[J]. Chin J Radio, 2017, 51(2): 114-118. DOI: 10.3760/cma.j.issn.1005-1201.2017.02.007.
Zhang F, Qu J, Zhang H, et al. Preoperative T staging of potentially resectable esophageal cancer: a comparison between free-breathing radial VIBE and breath-hold cartesian VIBE, with histopathological correlation[J]. Transl Oncol, 2017, 10(3): 324-331. DOI: 10.1016/j.tranon.2017.02.006.
Riddell AM, Hillier J, Brown G, et al. Potential of surface-coil MRI for staging of esophageal cancer[J]. Am J Roentgenol, 2006, 187(5): 1280-1287. DOI: 10.2214/AJR.05.0559.
Yamada I, Izumi Y, Kawano T, et al. Superficial esophageal carcinoma: an in vitro study of high-resolution MR imaging at 1.5T[J]. Magn Reson Imaging, 2001, 13(2): 225-231. DOI: 10.1002/1522-2586(200102)13:2<225::aid-jmri1033>;2-z.
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[J]. Cancer Imaging, 2020, 20(1): 64-74. DOI: 10.1186/s40644-020-00343-w.
Wang ZQ, Zhang FG, Guo J, et al. A comparison between 3.0 T MRI and histopathology for preoperative T staging of potentially resectable esophageal cancer[J]. Natl Med J China, 2017, 97(11): 843-846. DOI: 10.3760/cma.j.issn.0376-2491.2017.11.010.
Wang Z, Guo J, Qin J, et al. Accuracy of 3-T MRI for Preoperative T Staging of Esophageal Cancer After Neoadjuvant Chemotherapy, With Histopathologic Correlation[J]. AJR Am J Roentgenol, 2019, 212(4): 788-795. DOI: 10.2214/AJR.18.20204.
Qu J, Shen C, Qin J, et al. The MR radiomic signature can predict preoperative lymph node metastasis in patients with esophageal cancer[J]. Eur Radiol, 2019, 29(2): 906-914. DOI: 10.1007/s00330-018-5583-z.

PREV The value of dynamic contrast enhanced‑magnetic resonance imaging based on compressed sensing volumetric interpolated breath-hold examination in the differential diagnosis between benign and malignant thyroid nodules
NEXT The study of enhanced MR radiomics combining clinical factors in predicting early recurrence of hepatocellular carcinoma after resection

Tel & Fax: +8610-67113815    E-mail: