Sonia Betancourt Cuellar;
The University of Texas, MD Anderson Cancer Center
Marcelo Benveniste;
The University of Texas, MD Anderson Cancer Center
Girish Shroff ;
The University of Texas, MD Anderson Cancer Center
Jeremy Erasmus;
The University of Texas, MD Anderson Cancer Center
Background
Clinical staging, evaluation of response to treatment and follow up in patients with esophageal carcinoma is performed with complementary imaging modalities: endoscopic ultrasound and biopsy, CT, and FDG-PET/CT. Given the importance of imaging at the initial staging and during and after treatment, we present several cases that illustrate concepts and definitions that must be understood during staging and follow up to avoid inappropriate therapy or unnecessary procedures.
Educational Goals / Teaching Points
Present cases that clarify important concepts to be considered during the clinical staging of patients with esophageal carcinoma. Illustrate cases with pitfalls and therapeutic complications during and after treatment in patients with esophageal carcinoma.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We are including 11 cases to illustrate specific situations during the initial staging, treatment, and follow up of patients with esophageal carcinoma. Cases will demonstrate TNM initial clinical staging pitfalls, and post-therapeutic complications during treatment and follow up, radiation-induced esophagitis, radiation-induced liver injury, development of metastases after preoperative chemoradiation, inflammatory changes at the anastomosis, increased uptake of FDG in muscle flap misinterpreted as recurrence, and recurrent disease.
Conclusion
Knowledge of key concepts in the staging of esophageal carcinoma and awareness of possible pitfalls on imaging and complications during and after treatment would increase the accuracy of staging and decrease the likelihood of misinterpretation during the evaluation of response to treatment and follow up.
