Abstract.
Background: To improve computed tomographic (CT) prediction of local irresectability and to correlate preoperative CT findings with patient outcome.
Methods: Eighty-five patients with esophageal carcinoma underwent CT in supine, left lateral decubitus, and prone positions. CT signs that were indicative of local irresectability included (1) an angle of contact >45° with the aorta; (2) obliteration of triangular fat pad between the tumor, aorta, and spine; (3) tumor contiguous with the aorta in all three positions; and (4) indentation of the airway in all three positions.
Results: All CT signs indicative for local irresectability concerning the aorta had comparable percentages of false-positive scans (75%) when correlated with surgical findings. When correlated with pathologic findings, >45° angle of contact with the aorta yielded the fewest false-positive cases (9%). Concerning the airway, additional positions changed the staging correctly in 1 of 18 cases. Median survival was 21 and 8 months, respectively, for tumors considered CT resectable or irresectable.
Conclusion: Additional patient positions do not improve the CT prediction of aortic invasion. Predicted resectability correlates with a significant longer life expectancy.
Similar content being viewed by others
Author information
Authors and Affiliations
Additional information
Received: 29 January 1996/Accepted: 13 March 1996
Rights and permissions
About this article
Cite this article
van den Hoed, R., Feldberg, M., van Leeuwen, M. et al. CT prediction of irresectability in esophageal carcinoma: value of additional patient positions and relation to patient outcome. Abdom Imaging 22, 132–137 (1997). https://doi.org/10.1007/s002619900157
Published:
Issue Date:
DOI: https://doi.org/10.1007/s002619900157