Published online Apr 28, 2012. doi: 10.4329/wjr.v4.i4.179
Revised: March 5, 2012
Accepted: March 12, 2012
Published online: April 28, 2012
AIM: To investigate contrast-enhanced computed tomography (CECT) for discriminating esophageal squamous cell carcinoma (ESCC) from normal esophagus and evaluating outcomes within tumors after chemoradiotherapy (CRT).
METHODS: Sixty-four patients with surgical ESCC served as group A, and underwent thoracic contrast-enhanced scan with 16-section multidetector row CT 1 wk before surgery. Thirty-five patients with advanced ESCC receiving 4-wk CRT and showing response to CRT served as group B, and underwent CT scans similar with group A 4 wk after completion of CRT. In group A, differences in CT attenuation values (in HU) between the preoperative ESCC and background normal esophageal wall (delta CT1), or between different background normal esophageal walls (delta CT2) were compared. Furthermore, delta CT1 between group A and B was also compared.
RESULTS: In group A, mean delta CT1 was higher than delta CT2 (23.86 ± 10.59 HU vs 6.24 ± 3.06 HU, P < 0.05). When a delta CT1 of 10.025 HU was employed at a cut-off value to discriminate ESCC from normal esophagus, a sensitivity of 89.1% and specificity of 90.6% were achieved. Mean delta CT1 was lower in group B than in group A (9.25 ± 10.86 vs 23.86 ± 10.59, P < 0.05), and a delta CT1 of 15.45 HU was obtained at a cut-off value to assess the CRT changes with a sensitivity of 76.6% and specificity of 77.1%.
CONCLUSION: CECT might be a clinical technique for discriminating ESCC from normal esophagus, and evaluating outcome in the tumors treated with CRT.