BACKGROUND:Positron emission tomography and computed tomography (PET-CT) is established in the staging of esophageal cancer. In this study, an MRI protocol was designed to emulate the anatomical (T1-weighed (T1W) and T2W imaging) and functional information (diffusion-weighted imaging) provided by PET-CT.METHODS:In all, 49 patients with carcinoma of the esophagus underwent PET-CT and whole-body MRI (WBMRI). WBMRI was carried out using dedicated sequences tailored to detect metastatic disease at each area corresponding to the anatomical coverage of PET-CT. Nodal status was determined from histopathology and endoscopic ultrasound biopsy (EUS).RESULTS:PET-CT and WBMRI identified the primary tumor in 46/49 (94%) and 48/49 (98%) patients, respectively. Nodal analysis in patients undergoing surgery (n = 18) yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 27, 100, 100, 47 and 56% for PET-CT, compared with 30, 100, 100, 53 and 61% for WBMRI. When nodal analysis included both surgical specimens and EUS criteria (n = 39), sensitivity, specificity, PPV, NPV and accuracy were 46, 91, 93, 40 and 59% for PET-CT compared with 59, 92, 94, 50 and 67% for WBMRI. Both imaging modalities identified distant metastases in 2 patients.CONCLUSION:WBMRI has similar accuracy to PET-CT in detecting the primary tumor, nodal deposits and for exclusion of systemic metastatic disease.

ANZ Journal of SurgeryVolume 85, Issue 9 p. 685-686 IMAGES FOR SURGEONS Diffuse oesophageal leiomyomatosis Gabriella Guevara MBBCh, BAO, Gabriella Guevara MBBCh, BAO Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorEabhann O'Connor MBBCh, BAO, Eabhann O'Connor MBBCh, BAO Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorOrla McCormack MD, FRCSI, Orla McCormack MD, FRCSI Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorMark Harmon MRCPI, FFRRCSI, Mark Harmon MRCPI, FFRRCSI Department of Radiology, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorStephen Finn FRCPath, FFacPath, RCPI, Stephen Finn FRCPath, FFacPath, RCPI Department of Histopathology, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorCian Muldoon FRCPath, FFacPath, RCPI, Cian Muldoon FRCPath, FFacPath, RCPI Department of Histopathology, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorNarayanasamy Ravi MD, FRCS, Narayanasamy Ravi MD, FRCS Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorJohn V. Reynolds MD, FRCS, John V. Reynolds MD, FRCS Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this author Gabriella Guevara MBBCh, BAO, Gabriella Guevara MBBCh, BAO Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorEabhann O'Connor MBBCh, BAO, Eabhann O'Connor MBBCh, BAO Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorOrla McCormack MD, FRCSI, Orla McCormack MD, FRCSI Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorMark Harmon MRCPI, FFRRCSI, Mark Harmon MRCPI, FFRRCSI Department of Radiology, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorStephen Finn FRCPath, FFacPath, RCPI, Stephen Finn FRCPath, FFacPath, RCPI Department of Histopathology, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorCian Muldoon FRCPath, FFacPath, RCPI, Cian Muldoon FRCPath, FFacPath, RCPI Department of Histopathology, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorNarayanasamy Ravi MD, FRCS, Narayanasamy Ravi MD, FRCS Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this authorJohn V. Reynolds MD, FRCS, John V. Reynolds MD, FRCS Department of Surgery, St. James's Hospital, Dublin, IrelandSearch for more papers by this author First published: 16 December 2013 https://doi.org/10.1111/ans.12492Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume85, Issue9September 2015Pages 685-686 RelatedInformation

picking up abnormal findings on CE images.To establish an easy, quick, precise and efficient diagnosis of CE examinations, we investigated the usefulness of the cloud and a remote desktop control, and their contribution to the analizing process.Materials and methods: Twenty subjects underwent CE at three local hospitals.After checking the real-time viewer remotely (using a remote desktop control) to ensure completion, patients returned to their hospitals and their video data was downloaded from the data recorder and then uploaded to a secure folder in the cloud which was synchronized to a diagnostic center workstation.Analysis software (Rapid Access ver.6;Given Imaging Co. Israel) was installed on the workstation and checking was done by an expert co-medical staff member, who picked up thumbnails that contained abnormal findings on CE video clips (first diagnostic step).An expert doctor at the diagnostic center then checked video clips and/or thumbnails picked up by the co-medical staff (second diagnostic step) and finally made a diagnosis.A doctor at each local hospital checked video clips and made a diagnosis.We compared the abnormal findings that were picked up by the local hospitals and the center hospital.We also measured uploading and synchronizing (downloading) times.Results: 1) The diagnostic center picked up 15% more abnormal findings than local hospitals, though all final diagnoses were the same.2) Synchronizing speed (downloading speed) was faster than 2 Mbyte/sec to the diagnostic center.It was possible to download a video clip file in ten minutes.On the other hand, uploading time was dependent on the provider's network, types of connection and cloud storage software.Some types of software have a function to accelerate uploading speed to nearly the same as the downloading one.3) By checking images remotely, combined with a position detector, we could minimize the examination time.Conclusion: This remote network support has the possibility to assure accuracy and speed up diagnosis times, though it may be necessary to shorten the uploading time to the cloud storage site by using file compression software.