Comparative Study On The Efficacy Of MRI New Multimodal Sequences And MDCT In T Staging Of Esophageal Cancer

Purpose Preoperative T staging of resectable esophageal cancer was performed by using the 3.0T MRI new multimodal Sequences and MDCT respectively.Then compare their T staging diagnostic efficiency to provide a reference for clinical selection of the best T staging inspection method.Material and method Prospectively and continuously collect the inpatients with esophageal cancer confirmed by biopsy in our hospital from May 2019 to July 2020,and perform MRI new multimodal Sequences(including high-resolution T2-TSE-BLADE sequence,high resolution T1-STAR-VIBE-FS after delayed contrast enhancement sequence)and MDCT dynamic enhancement examination within 3-7 days after biopsy.Two attending radiologist with more than 8 years of work experience assessed the quality of the images,and excluded cases that could not meet the imaging diagnosis.Under double-blind conditions,two readers separately used high-resolution T2-TSE-BLADE sequence,high-resolution T1-STAR-VIBE-FS delayed enhancement sequence,MRI combined sequence(high-resolution T2-TSE-BLADE sequence + delayed enhancement high-resolution T1-STAR-VIBE sequence),and MDCT dynamic enhancement for T staging of esophageal cancer,Kappa consistency test was used to evaluate the consistency of preoperative T staging between two radiologists.After discussing and agreeing on the different staging cases,the sensitivity,specificity,Youden index and consistency test Kappa value of the above four T staging methods are calculated according to the pathological T staging standard to compare their staging efficiency.All data are statistically analyzed using SPSS version 25.0 software.Result This study finally enrolled 45 patients with resectable esophageal cancer in our hospital from May 2019 to July 2020.Postoperative pathological T staging: 11 cases(24.4%)in T1 stage,11 cases(24.4%)in T2 stage,17 cases(37.8%)in T3 stage,and 6 cases(13.3%)in T4 a stage.The kappa values of the consistency test of the two readers with different T staging methods were greater than 0.84,which showed good consistency.The results of this study:(1)The sensitivity and Youden index of T1-STAR-VIBE-FS sequence to T1-T2 phase are higher than T2-TSE-BLADE sequence,but the specificity is the same,indicating that the comprehensive diagnostic efficiency of t1-star-vibe-fs sequence was better than t2-tse-blade sequence in T1-T2 phase;(2)The sensitivity and Youden index of T2-TSE-BLADE sequence to T3 stage are higher than T1-STAR-VIBE-FS sequence,but the specificity is only slightly lower,indicating that the comprehensive diagnostic efficiency of T2-TSE-BLADE sequence was better than T1-STAR-VIBE-FS sequence in T3 phase;(3)The sensitivity,specificity and Youden index of MRI combined sequence staging for stage T1-T4 a are the highest,indicating that its comprehensive diagnostic efficiency is the best;(4)The sensitivity,specificity and yoden index of MDCT for T1-T3 stage were mostly ranked in the third or fourth place,indicating that the comprehensive diagnostic efficiency of MDCT was in the middle or lower level in each staging method;(5)The sensitivity,specificity and Youden index of each staging method for T4 a are the same,indicating that their comprehensive diagnostic efficacy is similar;(6)The kappa value of each staging method according to the consistency analysis of pathological criteria: MRI combined sequence > t1-star-vibe-fs sequence > t2-tse-blade sequence > 0.75 > MDCT staging,which indicating that the three staging methods of MRI had good consistency with pathological criteria,and all have better consistency than MDCT,and MRI combined sequence staging has the highest consistency.Discussion and Conculsion The results of this study show that both Unimodal and multimodal combined MRI sequences had good efficacy in the T-staging of esophageal cancer,and MRI multimodal combined sequence had the highest efficacy,and were superior to MDCT.Among them,t1-star-vibe-fs sequence can clearly display the mucous layer and muscular layer,which is better for the diagnosis of T1-T2 stage;t2-tse-blade sequence can clearly display the outer membrane layer,which is better for the diagnosis of T3 stage.In summary,the MRI new multimodal sequence has higher soft tissue resolution,and its diagnostic efficiency is better than MDCT.It can be routinely applied to preoperative T staging of esophageal cancer.