Evaluation of combination of multiple MRI sequences in the differential diagnosis of esophagus cancer

Abstract

Objective To evaluate the role of combination of multiple MRI sequences in the differential diagnosis of esophagus cancer and to assess the accordance among radiologists with different experience. Methods Thirty-fifty patients underwent conventional MRI including T2 weighted (T2) sequences, gadolinium fat-suppressed T1 weighted sequences (post-contrast T1), and DWI sequences. Three radiologists with different experience determined the possibility of local recurrence (LR) on T2, T2+post-contrast T1, T2+DWI, and T2+post-contrast T1+DWI. ROC and Kappa were used. Results In total, 13 patients had LR. On T2WI, the ROC curve (AUC) achieved by the senior,intermediate and junior groups were 0.701,0.407,and 0.584, respectively.Compared with simple T2WI sequences, DWI and T1 Gd significantly improved the AUC value for the intermediate radiologist. The great difference was observed between radiologists of different experience (Kappa coefficient was from 0.227 to 0.884). Combination of multiple sequences significantly reduced the diagnostic differences between radiologists with different experience for the senior radiologists particularly. Conclusions The addition of DWI and T1 post-contrast MRI increased diagnostic ability for LR of esophagus cancer and reduced the diagnostic differences between radiologists with different experience compared to T2WI. Key words: Esophagus neoplasms; Magnetic resonance imaging; Diffusion-weighted imaging