A comparison between free-breathing radial VIBE in 3T MR and endoscopic ultrasound for preoperative T staging of potentially resectable esophageal cancer with histopathological correlation
Jinrong Qu1,2, Hui Liu3, Zhaoqi Wang2, Ihab R Kamel4, Kiefer Berthold5, Robert Grimm5,6, Jianjun Qin7, and Hailiang Li1

1Radiology, Henan Cancer Hospital, Zhengzhou, China, People's Republic of, 2Radiology, the affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China, People's Republic of, 3MR Collaboration, Siemens Healthcare, Shanghai, China, People's Republic of, 4Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, 5MR Pre-development, Siemens Healthcare, Erlangen, Germany, 6Erlangen, Germany, 7Thoracic surgery, Henan Cancer Hospital, Zhengzhou, China, People's Republic of

Synopsis

Contrast-enhanced free-breathing r-VIBE is superior to EUS in T staging of potentially resectable EC, not only for T1 and T2, but also for T3 and T4.

Introduction Currently, endoscopic ultrasound (EUS) is considered as the gold imaging standard for esophageal cancer (EC) staging. The purpose of this study is to compare the T staging of potentially resectable EC using a free-breathing radial VIBE and EUS with pathologic confirmation of the T stage. Materials and Methods Patients with endoscopically proven EC and indeterminate T1/T2/T3/T4a stage by CT scan and EUS were examined on a 3T scanner (MAGNETOM Skyra, Siemens Healthcare, Erlangen, Germany). The MRI protocol included a prototype free-breathing radial VIBE (r-VIBE) (1) with isotropic spatial resolution (1.1 mm x 1.1 mm x 1.1 mm) at [MB1] 160 sec post IV contrast. Two independent readers assessed the image quality with 5 scores and T stage on MRI according to the 7th edition of UICC-AJCC TNM Classification (T1: Tumor invades mucosa, muscularis mucosa and submucosa. T2: Tumor invades muscularis propria. T3: Tumor invades adventitia. T4a: Resectable tumor invading pleura, pericardium, or diaphragm; T4b: Unresectable tumor invading other adjacent structures, such as the aorta, vertebral body, and trachea), and compared between r-VIBE and EUS with post-operative pathologic confirmation which was considered the gold standard. Inter-reader agreement was also calculated. Results The patient population consisted of 43 individuals. The inter-reader agreement of T staging was also good for r-VIBE (Kappa=0.748, P=0.000). Comparison between EUS and pathologic T staging showed the T staging agreement was 69.8% (30/43). The T staging agreement between r-VIBE and post-operative pathologic T staging was 86.0% (37/43) for reader 1 and 90.7% (39/43) for reader 2. Both readers achieved higher accuracy for T1/T2 stage using r-VIBE (90.5%-100%) and EUS (100%). For T3/T4, both readers had higher accuracy using r-VIBE (81.8%-90.9%) compared to EUS (68.2%) by one reader. Conclusion Contrast-enhanced free-breathing r-VIBE is superior to EUS in T staging of potentially resectable EC, not only for T1 and T2, but also for T3 and T4. [MB1]Was that the beginning of the scan, the center? Radial VIBE is contrast sensitive over the whole scan duration.

Acknowledgements

No acknowledgement found.

References

[1] KT Block et al, JKSMRM 18(2), 2014

Figures

Table 1 Comparison between pre-operative EUS T staging and post-operative pathologic T staging (n=43) by one reader for potentially resectable EC.

Table 2 Pre-operative free-breathing r-VIBE T staging and post-operative pathologic T staging (n=43) of potentially resectable EC .



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
0981