Kristina Imeen Ringe MD, Presenter: Nothing to Disclose

Simone Meyer, Abstract Co-Author: Nothing to Disclose

Frank K. Wacker MD, Abstract Co-Author: Research Grant, Siemens AG Research Grant, Pro Medicus Limited

Hans-Juergen Raatschen MD, Abstract Co-Author: Nothing to Disclose

To assess the added value of oral effervescent powder (EP) administration for detection and T-staging of esophageal cancer at contrast-enhanced CT, as compared to studies without EP.

84 patients without esophageal pathology and 52 patients with histological confirmed diagnosis of esophageal cancer referred for CT were included in this prospective IRB-approved study (99m/37f, mean age 61y). Half of the patients of each group were orally administered 3g effervescent powder (EP) prior to image acquisition. Esophageal distension was assessed (proximal/middle/distal/tumor level) by measurement of the inner (IA) and outer area (OA). Two blinded readers separately evaluated all datasets regarding diagnosis of esophageal cancer (yes/no) and T-staging (T0-T4), if applicable. Distension results were compared (t-Test). In patients with cancer sensitivity, specificity, negative (NPV) and positive (PPV) predictive values were calculated. CT staging results were evaluated (Cohen-k) and compared with histopathology as reference standard, which was obtained within four weeks of imaging.

IA and quotient IA/OA were significantly larger at all levels after EP as compared to the control (p<0.05; mean IA:1.1 vs. 0.42, mean IA/OA:0.34 vs. 0.13). For both readers sensitivity, specificity, NPV and PPV for detection of cancer were as follows: 78%/78%, 98%/98%, 95%/95%, 87%/87% after EP; 60%/68%, 98%/98%, 94%/94%, 80%/83% without EP. T-Staging after EP was good (k=0,838/0,674) and moderate without EP (k=0,576/0,592). Interobserver agreement for detection and staging of tumor was very good (k=0,830) and good (k=0,741) after EP, and good (k=0,774) and moderate (k=0,591) without EP, respectively.

Oral administration of effervescent powder at CT results in good distension of the esophagus, and improves detection and T-staging of esophageal cancer, as compared to control studies without effervescent powder.

Oral administration of effervescent powder at CT improves detection and T-staging especially of subtle lesions (T1 and T2 tumors) in patients with esophageal cancer.

Ringe, K, Meyer, S, Wacker, F, Raatschen, H, Value of Oral Effervescent Powder Administration for Multidetector CT Evaluation of Esophageal Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009075.html