AIMS: To assess the strength of agreement between the perceived pre-operative stage of oesophageal tumours as determined by spiral computed tomography (CT) and endoscopic ultrasound (EUS), both alone and in combination, with the histopathological stage. METHODS: Sixty patients with oesophageal cancer underwent both pre-operative CT and EUS performed by two consultant radiologists with a special interest in upper gastrointestinal radiology. The strength of the agreement between the radiological stage and the histopathological stage was determined by means of the weighted Kappa statistic (Kw). RESULTS: Sensitivity for T and N stages was 58% and 79% for CT, and 72% and 91% for EUS. Specificity for T and N stages was 80% and 84% for CT, and 85% and 68% for EUS. Kw for T and N stages was 0.455 (p=0.0001) and 0.603 (p=0.0001) for CT compared with 0.604 (p=0.0001) and 0.610 (p=0.0001) for EUS. In patients when CT and EUS agreed regarding the T and N stages, the strength of agreement between the radiological and the histopathological stage was greater (Kw T 0.613 (p=0.0001), Kw N 0.781 (p=0.0001)). CONCLUSION: CT and EUS are complimentary techniques for the staging of oesophageal tumours, and these results reinforce the importance of specialist radiology in stage directed management.
AIMS: To assess the strength of agreement between the perceived pre-operative stage of oesophageal tumours as determined by spiral computed tomography (CT) and endoscopic ultrasound (EUS), both alone and in combination, with the histopathological stage. METHODS: Sixty patients with oesophageal cancer underwent both pre-operative CT and EUS performed by two consultant radiologists with a special interest in upper gastrointestinal radiology. The strength of the agreement between the radiological stage and the histopathological stage was determined by means of the weighted Kappa statistic (Kw). RESULTS: Sensitivity for T and N stages was 58% and 79% for CT, and 72% and 91% for EUS. Specificity for T and N stages was 80% and 84% for CT, and 85% and 68% for EUS. Kw for T and N stages was 0.455 (p=0.0001) and 0.603 (p=0.0001) for CT compared with 0.604 (p=0.0001) and 0.610 (p=0.0001) for EUS. In patients when CT and EUS agreed regarding the T and N stages, the strength of agreement between the radiological and the histopathological stage was greater (Kw T 0.613 (p=0.0001), Kw N 0.781 (p=0.0001)). CONCLUSION: CT and EUS are complimentary techniques for the staging of oesophageal tumours, and these results reinforce the importance of specialist radiology in stage directed management.
Authors: L Davies; J D Mason; S A Roberts; D Chan; T D Reid; M Robinson; S Gwynne; T D Crosby; W G Lewis Journal: Surg Endosc Date: 2012-04-26 Impact factor: 4.584
Authors: Christopher P Twine; S Ashley Roberts; Wyn G Lewis; B Vicki Dave; Claire E Rawlinson; David Chan; Mark Robinson; Tom D Crosby Journal: Surg Endosc Date: 2010-04 Impact factor: 4.584
Authors: Christopher P Twine; S Ashley Roberts; Jonathan D Barry; Huw Oliphant; Matthew A Morgan; Guy R J Blackshaw; Wyn G Lewis Journal: Eur Radiol Date: 2008-10-29 Impact factor: 5.315
Authors: Christopher P Twine; Wyn G Lewis; Xavier Escofet; David Bosanquet; S Ashley Roberts Journal: Surg Endosc Date: 2009-05-14 Impact factor: 4.584
Authors: Christopher P Twine; Jonathan D Barry; Guy R J Blackshaw; Tom D Crosby; S Ashley Roberts; Wyn G Lewis Journal: Surg Endosc Date: 2009-01-01 Impact factor: 4.584