All authors have significantly contributed to this work based on the guidelines of the International Committee of Medical Journal Editors.
Distance between the esophageal tumor and the aorta measured by using the contrast-enhanced attenuation on computed tomography for predicting this tumor invading aorta
Article first published online: 22 JAN 2013
© 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 28, Issue 2, pages 297–302, February 2013
How to Cite
Tsujimoto, H., Matsumoto, Y., Kumano, I., Takahata, R., Yoshida, K., Horiguchi, H., Nomura, S., Ono, S., Yamamoto, J. and Hase, K. (2013), Distance between the esophageal tumor and the aorta measured by using the contrast-enhanced attenuation on computed tomography for predicting this tumor invading aorta. Journal of Gastroenterology and Hepatology, 28: 297–302. doi: 10.1111/jgh.12064
- Issue published online: 22 JAN 2013
- Article first published online: 22 JAN 2013
- Accepted manuscript online: 28 NOV 2012 07:24AM EST
- Manuscript Accepted: 30 OCT 2012
- cancer imaging;
- esophageal cancer;
- multidetector CT;
- tumor infiltration
Background and Aim
Despite remarkable advances in diagnostic modalities, preoperative assessment of the local tumor extent in esophageal cancer is still very difficult. The aim of this study was to evaluate the predictive value of the computed tomography (CT) attenuation value between the tumor and the aorta for esophageal cancer.
Consecutive CT values were determined between the center of the tumor and the center of the aorta. The distance between the intersection of the average CT attenuation value of the tumor using the lower CT attenuation value of the inclusion tissues (T–A distance) was determined. The minimal CT attenuation value and the overall circumference of contact area (Picus' angle) were also determined. This study included 101 patients suspected of having a tumor invading the adventitia and evaluated the capacity of these parameters for predicting the aortic invasion.
The T–A distance in patients who were diagnosed without aortic invasion was significantly longer than patients who were pathologically confirmed to have invasion to the aortic wall [pT4(Ao)] (P < 0.05). The minimal CT attenuation value in patients without aortic invasion was significantly lower than pT4(Ao) patients (P < 0.05), although such a difference was not observed for the Picus' angle. The T–A distance (1.3 mm >) is the most reliable feature for predicting the aortic invasion, according to the results of the area under the receiver operating characteristic curve.
The assessment of the T–A distance is simple and objective, and it can help prevent unnecessary surgery in patients with inoperable tumors.