Abstract
Simple SummaryA chest CT via central vein enhancement not only eliminates peripheral vein regurgitation but also provides better image quality that facilitates precise clinical staging. A chest CT via central vein enhancement may be considered after tissue proof in order to better discriminate disease severity.The differences in chest computed tomography (CT) image quality may affect the tumor stage. The aim of this study was to compare the image quality and accuracy of chest CT via central vein and peripheral vein enhancement. Fifty consecutive patients were enrolled from a tertiary medical center in Taiwan from May 2016 to March 2019. All the patients received a chest CT via central vein enhancement prior to neoadjuvant concurrent chemoradiation in order to compare the chest CT that was obtained via the peripheral vein. In addition, blind independent central reviews of chest CT via central vein and peripheral vein enhancement were conducted. For T and N stage, chest CT via central vein enhancement had a greater consistency with endoscopic ultrasonography and positron-emission tomography-computed tomography findings (kappa coefficients 0.4471 and 0.5564, respectively). In addition, chest CT via central vein enhancement also showed excellent agreement in the blind independent central review (kappa coefficient 0.9157). The changes in the T and N stage resulted in stage migration in 16 patients. Chest CT via central vein enhancement eliminated peripheral vein regurgitation and also provided more precise clinical staging. This study is registered under the registered NCT number 02887261.
Highlights
Introduction distributed under the terms andA secure vascular access is crucial for oncology patients, such as those with esophageal cancer [1]
There were no significant differences in the tumor measurements, including tumor volume and esophageal wall thickness, between the computed tomography (CT) via central vein and peripheral vein enhancement (Table 1)
We found that the CT via peripheral vein enhancement had fair agreement with the Positron Emission Tomography (PET)-CT (Table 4A and Table S3; kappa coefficient = 0.3986), but there was only moderate agreement between the CT via central vein enhancement and the PET-CT (Table 4B and Table S3; kappa coefficient = 0.4299)
Summary
Introduction distributed under the terms andA secure vascular access is crucial for oncology patients, such as those with esophageal cancer [1]. Were needed until the central venous puncture technique was developed by Aubaniac in [2]. The first totally implantable venous device, i.e., an intravenous port, was designed by Niederhuber and introduced into clinical practice in 1982 [5]. The pressure rating of an intravenous port is 10 to 15 atm (145 to 174 psi), which is not suitable for the injection of contrast medium [6]. The need for venous puncture cannot be completely avoided, and the possibility of extravasation remains. In order to overcome this problem, a power injectable port that is rated for high pressure injections (300 to 325 psi) was designed and is widely utilized in clinical practice
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