High-resolution 3.0 T MR imaging of esophageal carcinoma with histopathological findings

Objective To prospectively determine the feasibility of high-resolution in vivo MR imaging in the evaluation of esophageal carcinoma invasion at 3.0 T. Methods One hundred and eighteen patients with esophageal carcinoma, proven by the gastroscopic biopsy, were prospectively studied using 3.0 T MR. The esophageal specimens were sectioned transversely to keep consistent in the orientation with the MR images, the histopathological stage was made and the thickness of the tumor on the largest diameter of the slice were measured. The MR images were reviewed in the transverse plane. According to the seventh American joint committee on cancer, the MR stage was made and the tumor's thickness was measured. The MR images and the histopathological slices were matched. The staging diagnostic efficacy of the MR imaging was evaluated with the histopathological results as the standard reference, Kappa test was used to compare the stage of MR imaging with that at the histopathological analysis. Bland-Altman scatterplots were used to compare the thickness of tumor measured on the MR images with that at the histopathological measurement. Results Ninety seven cases (82.2%,97/118) of MR stage were accurately made, including 7 T1a,15 T1b,18 T2, 25 T3 and 32 T4a cases, furthermore, 14 cases were over staged and 7 cased were underestimated. The MR stage was highly consistent with the histopathological stage (Kappa=0.772).The sensitivity for the staging of high-resolution MR imaging at 3.0 T was 58.3%(7/12) to 100.0%(32/32),the specificity was 95.3%(82/86) to 98.1%(104/106), and the accuracy was 91.5%(108/118) to 96.6%(114/118), respectively. Bland-Altman scatterplots demonstrated that the discrepancy of the mean thickness between the value obtained by three radiologists respectively and the histopathological analysis were 2.0, 2.6 and 2.1 mm, which demonstrated a good consistency. Conclusion High-resolution MR images obtained at 3.0 T can be used to evaluate the depth of carcinoma invasion and provide excellent diagnostic accuracy for preoperative staging. Key words: Magnetic resonance imaging; Esophageal neoplasms; Neoplasm staging