2008 Volume 59 Issue 5 Pages 445-451
Rapid advances have been seen recently in imaging modalities and analytical software for radiological imaging of digestive cancer disease, which started from diagnosis of existence and qualitative diagnosis. Today, in addition to the previous TNM staging technique a new imaging technology has been developed. The new technology, which we have named “functional imaging”, enables biological evaluation of the malignant potential of cancer, including tissue blood flow, tissue metabolism and cell activity. In this paper concerning esophageal squamous cell cancer, we described both the current status of radiological imaging and this new imaging technology for the near future.
The new imaging technique mainly consists of diffusion-weighted magnetic resonance imaging (DWI), CT perfusion and high-barium radiography using a flat panel X-ray detector (FPD). From our earlier data, we recognize that DWI is possible of a good diagnostic power by no means inferior to FDG-PET in detecting nodal metastasis. Chemoradiotherapy effect is predicted by evaluating tumor blood flow using CT perfusion. High-barium esophagography with FPD enables discrimination of superficial cancer. New diagnostic imaging may be established using these technologies.
