@article{oai:repo.qst.go.jp:00045852,
 author = {Umeoka, Shigeaki and Koyama, Takashi and Watanabe, Go and Saga, Tsuneo and Kataoka, Masako and Togashi, Kaori and Hatabu, Hiroto and 佐賀 恒夫},
 issue = {3},
 journal = {Journal of Computer Assisted Tomography},
 month = {May},
 note = {Purpose: To evaluatewhether the accuracy of local extension (T-staging) of esophageal carcinoma could be improved with addition of arterial phase images by use of multiYdetector row computed tomography.
Materials and Methods: The institutional review board approved this study, and all the subjects provided informed consent. Dual-phase (the arterial and venous phases) contrast-enhanced computed tomography was performed in 45 consecutive patients (39 men and 6 women;
age range, 47Y84 years) with 47 lesions of esophageal carcinoma who underwent surgical intervention. Two radiologists independently evaluated the T-staging of esophageal carcinoma on both phases. The Tstaging on both the arterial and venous phase images was compared with the T-staging at histologic evaluation by means of a resected specimen (as the reference standard). Differences in the overall accuracy and sensitivity for the T-staging between the 2 phases were analyzed with the
McNemar test.
Results: The analysis of the interobserver agreement for T-staging showed almost perfect agreement (J = 0.85 on the arterial phase and J = 0.93 on the venous phase). The overall accuracy in the arterial phase was significantly better than that in the venous phase (68% vs 51%,
P < 0.01). The sensitivity values of the T-staging in the arterial phase were 0% in T1a, 71.4% in T1b, 12.5% in T2, 89.5% in T3, and 100% in T4. The sensitivity values in the venous phase were 0% in T1a, 14.3% in T1b, 0% in T2, 94.7% in T3, and 100% in T4. Statistical significance was apparent in the sensitivity of the T1b lesions.
Conclusion: The arterial phase can improve the accuracy of T-staging of esophageal carcinomas, especially early-staged lesions.},
 pages = {406--412},
 title = {Preoperative local staging of esophageal carcinoma using dual-phase contrast-enhanced imaging with multi-detector row computed tomography: value of the arterial phase images.},
 volume = {34},
 year = {2010}
}