Dependence of axis deviation in the esophagram on computerized tomography determined wall thickness and its value in assessing depth of invasion of esophageal carcinoma

PURPOSE: In this study we compared the abnormalities of the esophageal axis seen in the esophagogram with the thickness of the esophageal wall measured by computed tomography. We have investigated, how exactly both methods assess the local tumor invasion according to the TNM criteria and whether there is a relation between the esophageal axis and the wall thickness. METHODS: In a retrospective study we examined the esophagograms of 65 tumor patients. Computed tomography examinations were available in 40 cases. Using a graphical method the wall thickness was transferred to the esophagograms under consideration of the different scales of the images. RESULTS: There is no correlation between the different types of distortion of the esophageal axis and the wall thickness in computed tomography. However, it can be demonstrated that the distortion results from specific fixation effects with the surrounding tissue. CONCLUSIONS: Both radiological methods cannot determinate the tumor invasion correctly.