PMID- 30758534
OWN - NLM
STAT- MEDLINE
DCOM- 20200708
LR  - 20200708
IS  - 2366-0058 (Electronic)
VI  - 44
IP  - 5
DP  - 2019 May
TI  - Analyzing the post-contrast attenuation of the esophageal wall on routine 
      contrast-enhanced MDCT examination can improve the diagnostic accuracy in 
      response evaluation of the squamous cell esophageal carcinoma to neoadjuvant 
      chemoradiotherapy in comparison with the esophageal wall thickness.
PG  - 1722-1733
LID - 10.1007/s00261-019-01911-w [doi]
AB  - PURPOSE: To evaluate the accuracy of the multidetector computed tomography (MDCT) 
      in the response evaluation of the esophageal squamous cell carcinoma (ESCC) to 
      neoadjuvant chemoradiotherapy (nCRT) by analyzing the thickness and post-contrast 
      attenuation of the esophageal wall after the nCRT. METHODS: Contrast-enhanced 
      (CE)-MDCT examinations in portal venous phase of one hundred patients with 
      locally advanced ESCC who received nCRT and underwent esophageal resection and 
      histopathology assessment of tumor regression grade (TRG) were retrospectively 
      analyzed by measuring the maximal thickness and mean density of the esophageal 
      wall in the segment involved by tumor and visually searching for hyperdense foci 
      within it. Diagnostic performance was evaluated using the ROC analysis. RESULTS: 
      Average attenuation of the esophageal wall had stronger diagnostic performance 
      for predicting pathologic complete regression (pCR) (AUC = 0.994; p < 0.001) in 
      relation to maximal esophageal wall thickness (AUC = 0.731; p < 0.001). Maximal 
      esophageal wall thickness </= 9 mm and average attenuation of the esophageal 
      wall </= 64 HU predicted pCR with the sensitivity, specificity, and overall 
      accuracy of 62.5%, 77.9%, and 73%, and 96.9%, 98.5%, and 98%, respectively. 
      Combination of both cutoff values enabled correct assessment of pCR with the 100% 
      accuracy. Visual detection of the hyperdense focus within the esophageal wall 
      predicted pCR with the sensitivity, specificity, and overall accuracy values of 
      100%, 94.1%, and 96%, respectively. CONCLUSION: Visual analysis and measurement 
      of post-contrast attenuation of the esophageal wall after the nCRT can improve 
      diagnostic accuracy of MDCT in the response evaluation of the ESCC to nCRT in 
      comparison with measuring the esophageal wall thickness.
FAU - Djuric-Stefanovic, Aleksandra
AU  - Djuric-Stefanovic A
AUID- ORCID: 0000-0002-5796-835X
AD  - Unit of Digestive Radiology (First Surgery University Clinic), Center of 
      Radiology and MR, Clinical Center of Serbia, Koste Todorovica 6, 11000, Belgrade, 
      Serbia. avstefan@eunet.rs.
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia. avstefan@eunet.rs.
FAU - Jankovic, Aleksandra
AU  - Jankovic A
AD  - Unit of Digestive Radiology (First Surgery University Clinic), Center of 
      Radiology and MR, Clinical Center of Serbia, Koste Todorovica 6, 11000, Belgrade, 
      Serbia.
FAU - Saponjski, Dusan
AU  - Saponjski D
AD  - Unit of Digestive Radiology (First Surgery University Clinic), Center of 
      Radiology and MR, Clinical Center of Serbia, Koste Todorovica 6, 11000, Belgrade, 
      Serbia.
FAU - Micev, Marjan
AU  - Micev M
AD  - Department of Pathology, First Surgery University Clinic, Clinical Center of 
      Serbia, Belgrade, Serbia.
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
FAU - Stojanovic-Rundic, Suzana
AU  - Stojanovic-Rundic S
AD  - Clinic for Radiation Oncology and Diagnostics, Department of Radiation Oncology, 
      Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
FAU - Cosic-Micev, Milena
AU  - Cosic-Micev M
AD  - Department of Pathology, First Surgery University Clinic, Clinical Center of 
      Serbia, Belgrade, Serbia.
FAU - Pesko, Predrag
AU  - Pesko P
AD  - First Surgery University Clinic, Clinical Center of Serbia, Belgrade, Serbia.
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Abdom Radiol (NY)
JT  - Abdominal radiology (New York)
JID - 101674571
RN  - 0 (Contrast Media)
SB  - IM
MH  - Aged
MH  - Carcinoma, Squamous Cell/*diagnostic imaging/pathology/therapy
MH  - Chemoradiotherapy
MH  - Contrast Media
MH  - Esophageal Neoplasms/*diagnostic imaging/pathology/therapy
MH  - Esophagus/diagnostic imaging/pathology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Multidetector Computed Tomography
MH  - Neoadjuvant Therapy
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
OTO - NOTNLM
OT  - Esophageal neoplasms
OT  - Multidetector computed tomography
OT  - Neoadjuvant therapy
OT  - Treatment outcome
EDAT- 2019/02/14 06:00
MHDA- 2020/07/09 06:00
CRDT- 2019/02/14 06:00
PHST- 2019/02/14 06:00 [pubmed]
PHST- 2020/07/09 06:00 [medline]
PHST- 2019/02/14 06:00 [entrez]
AID - 10.1007/s00261-019-01911-w [pii]
AID - 10.1007/s00261-019-01911-w [doi]
PST - ppublish
SO  - Abdom Radiol (NY). 2019 May;44(5):1722-1733. doi: 10.1007/s00261-019-01911-w.