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Critical Role of T2-Weighted Imaging Combined with Diffusion-Weighted Imaging of MRI in Diagnosis of Loco-Regional Recurrent Esophageal Cancer After Radical Surgery

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J Zhang

G Deng1 , N Liang2 , J Xie3 , J Zhang4*, L Qiao5 , H Luo6 , J Zhang7 , (1) Department of Oncology, Shandong University School of Medicine, Jinan, Shandong, (2) Department of Radiation Oncology, Qianfoshan Hospital Affiliated to Shandon, Jinan, Shandong, (3) Department of Radiation Oncology, Qianfoshan Hospital Affiliated to Shandon, Jinan, Shandong, (4) Department of Radiation Oncology, Qianfoshan Hospital Affiliated to Shandon, Jinan, Shandong, (5) Department of Oncology, Shandong University School of Medicine, Jinan, Shandong, (6) Division of Oncology, Department of Graduate, Weifang Medical College,Weifang, Shandong, (7) Division of Oncology, Department of Graduate, Weifang Medical College,Weifang, Shandong

Presentations

SU-E-P-33 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall


Purpose:
We perform this study to investigate the diagnostic efficacy of T2-weighted MRI (T2WI) and diffusion-weighted MRI (DWI) in confirming local relapses of esophageal cancer in patients highly suspected of recurrence after eradicating surgery.

Methods:
Forty-two postoperative esophageal cancer patients with clinical suspicions of cancer recurrence underwent 3.0T MRI applying axial, coronal, sagittal T2WI and axial DWI sequences. Two experienced radiologists (R1 and R2) both used two methods (T2WI, T2WI+DWI) to observe the images, and graded the patients ranging from 1 to 5 to represent severity of the disease based on visual signal intensity (patients equal to or more than grade 3 was confirmed as recurrent disease)

Results:
27/42patients were verified of recurrent disease by pathologic findings and/or imaging findings during follow-up. The sensitivity, specificity and accuracy of R1 applying T2WI+DWI are 96%, 87% and 93% versus 81%, 80% and 77% on T2WI, these figures by R2 were 96%, 93% and 95% versus 89%, 93% and 90%. The receiver operating curve (ROC) analyses suggest that both of the two readers can obtain better accuracy when adding DWI to T2WI compared with T2WI alone. Kappa test between R1 and R2 indicates excellent inter-observer agreement on T2WI+DWI.

Conclusion:
Standard T2WI in combination DWI can achieve better accuracy than T2WI alone in diagnosing local recurrence of esophageal cancer, and improve consistency between different readers.


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