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CT Pre-Operative Imaging of the Esophagus: Is Inclusion of Abdomen Necessary?
Abstract
Background: Esophageal carcinoma is the third commonest tumor in Kenya with one of the highest mortality rates. Locally, the 2019 Kenya National Cancer Treatment Protocols recommend CT chest and abdomen as the basic imaging tool. The aim of this study was to determine the necessity of including the abdomen while scanning patients with cancer of the esophagus.
Methods: Fifty consecutive patients with esophageal cancer who underwent CT imaging were included.
Results: 32 male patients (64%) and 18 (36%) female patients. 4 patients (8%) had a CT diagnosis of upper third cancer of the esophagus; 20 patients (40%) had middle third cancer; and 26 patients (52%) had lower third cancer. Patients with middle and lower third esophagus tumors had nodal and distant metastases to the upper abdomen.
Conclusion: Preoperative CT with the inclusion of abdomen is essential for patients with middle and lower third tumors. None of the patients with upper third tumors had metastases to the abdomen. Further studies with a larger sample size are needed to assess the necessity of including abdomen in CT scan in these patients.
Keywords: Esophageal cancer, CT scan, Abdomen, Diagnostic yield