Abstract
The purpose of this study was to assess the effectiveness of the apparent diffusion coefficient (ADC) using diffusion-weighted imaging (DWI) for the clinical staging of esophageal cancer. The ADC of the tumors was compared to the standardized uptake value (SUV) of 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET). A total of 123 consecutive patients with esophageal squamous cell cancer were enrolled. DW images were obtained using a 1.5T whole-body scanner equipped with a phased-array body coil. A single shot spin-echo type of echo-planar sequence that provided diffusion weighting in the direction of the slice selection was used to obtain DW images. There was a negative correlation between the ADC value of the tumors and tumor diameter. A negative correlation was also found between the ADC value/SUV of the FDG-PET and serum levels of the tumor markers squamous cell carcinoma antigen and CYFRA. The ADC value was significantly correlated with clinical T and N stages. The ADC values of advanced-stage tumors were significantly lower than those of early-stage tumors. The ADC value of esophageal cancer decreased as the clinical stage advanced, and was correlated with the clinical findings. This non-invasive modality may be a valid clinical imaging method for the staging of esophageal cancer.
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