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DOI: 10.1148/radiol.2362040748
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(Radiology 2005;236:535-544.)
© RSNA, 2005

Gastrointestinal Imaging

Superficial Esophageal Cancer: Esophagographic Findings Correlated with Histopathologic Findings1

Seung Soo Lee, MD, Hyun Kwon Ha, MD, Jae Ho Byun, MD, Yong Moon Shin, MD, Hyung-Jin Won, MD, Ah Young Kim, MD, Pyo Nyun Kim, MD, Moon-Gyu Lee, MD, Soon Jin Lee, MD, Byung Hee Lee, MD and Soo Yil Chin, MD2

1 From the Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea (S.S.L., H.K.H., J.H.B., Y.M.S., H.J.W., A.Y.K., P.N.K., M.G.L.); Department of Radiology and Center for Imaging Science, Sungkyunkwan University School of Medicine, Seoul, Korea (S.J.L.); and Department of Radiology, Korea Cancer Center Hospital, Seoul, Korea (B.H.L., S.Y.C.). Received April 25, 2004; revision requested July 12; revision received September 1; accepted October 15. Address correspondence to H.K.H. (e-mail: hkha{at}www.amc.seoul.kr).

PURPOSE: To retrospectively determine and evaluate the findings of superficial esophageal cancer at esophagography and to correlate the esophagographic findings with the depth of tumor invasion.

MATERIALS AND METHODS: The institutional review boards required neither their approval nor informed patient consent for this retrospective study. One hundred thirteen patients with superficial esophageal cancer who underwent esophagectomy at three institutions were included in this study. Double-contrast esophagograms were reviewed independently by two reviewers. For assessment of histopathologic findings, pathology reports were reviewed. Findings at esophagography, including morphologic type of the lesion, lesion extent, presence or absence of elevated or depressed component, margin and extent of elevated or depressed component, presence or absence of nodularity, extent of nodularity, esophageal luminal narrowing, and esophageal wall rigidity, were compared between mucosal and submucosal cancers by using {chi}2, Fisher exact, and independent-sample t tests.

RESULTS: Of 122 histopathologically proved superficial esophageal cancers in 113 patients, 100 (82%) were detected at esophagography. The most common morphologic type was the plaquelike form; 50 (50%) such lesions were depicted at esophagography. Morphologic types were significantly different between the mucosal and submucosal cancers (P < .001). Protruded and plaquelike lesions were more frequent among submucosal cancers, whereas most flat lesions were mucosal cancers. An elevated component (P < .001), a rigid esophageal wall (P < .001), and a lobulated or irregular margin of the elevated component (P = .023) were significantly more frequent among submucosal cancers. Also, total extent of the lesion (P < .001), size of the largest nodule (P < .001), and extent of nodularity (P = .036) were significantly larger in the submucosal cancers.

CONCLUSION: In the evaluation of patients with superficial esophageal cancer, esophagography appears to be helpful for diagnosing the tumor and differentiating mucosal from submucosal cancers.

© RSNA, 2005