ROLE OF CT IMAGING AND STAGING OF ESOPHAGUS CARCINOMA

Abstract

In worldwide carcinoma esophagus is eight most commonly occurring carcinoma. It is a common cause of cancer deaths in developing countries. Among all cancers carcinoma of esophagus is also one of the most lethal cancers. In India especially Jammu and Kashmir is one of the states where there is high incidence of esophageal cancer of the "CentralAsian esophageal cancer belt". Esophagus is well seen on CT images throughout its course. The last decade, computerized tomography (CT) technology has led to an early detection of cancers which helps for decreasing mortality rate. Due to introduction of multi detector computerized tomography (MDCT) scanner is a blessing to clinical imaging practice. Due to latest applications demand for better technology use of CT has continuously increased. Aims:  the main objective is to evaluate the role of computerized tomography scan (CT scan) in detecting staging of esophageal cancer. Material and methods: The is a prospective study which was carried out in the Department of Radio diagnosis, Shri Vinoba Bhave Civil Hospital, Silvassa DNH India during  a period of 1 year.  Total 100 patients presenting with clinical symptoms and signs pertaining to carcinoma of esophagus were included in this study.  For all these patients, on the basis of histopathological examination (HPE) report i.e. those patients in which HPE report confirmed presence of carcinoma of esophagus were include in this study and CT findings were confirmed by biopsy report, postoperative study or follow up CT scan.  Result:  Patients of age group between 20 to 80 years were included in this study. The most age prevalence in study was between 41-60 yrs. Out of 50 patients 54% male and 46% female was affected. There is a significant of male among the patients studied, which furthermore corresponds favorably with similar studies worldwide. It shows that the middle and lower third of esophagus is more affected by esophagus carcinoma than upper third esophagus as shown in above table. According to studies till date, there is no mortality had been reported in esophagus carcinoma staging. However, staging was maximum in T3 stage patients 28 (56%) followed by 13(26%) patients with T1 and T2 staging and least 9 (18%) accounted for T4 staging. The most common asymmetrical wall thickening was observed in maximum number of patients 32 (64%) and Symmetrical wall thickening was observed 18 (36%) of patients. Conclusion:  CT scan plays significant role in preoperative staging of esophageal cancer. CT scan is only modality which has established improvement of esophageal cancer and operation resection rate in treatment. Therefore it is rapid and noninvasive modality to evaluate local extension of the tumor and to detect distant metastases and lymphadenopathies.

Keywords: Esophagus carcinoma, CT scan, staging,  Multidetector computerized tomography