[Oesophageal tumours--what does the surgeon need from the radiologist?]

Abstract

Surgery is the most important therapeutic discipline for oesophageal cancers and the surgeon has specific questions for the radiologist which can require various imaging procedures. The radiological presentation is, for example, necessary for the topographic imaging of larger space occupying processes, the localization and axial spread of which are important for the surgical procedure chosen. Imaging diagnostics helps with the identification of R0 resectable patients. High resolution computed tomography (CT) of the mediastinum is used to clarify the spatial relationship between oesophageal cancer and the tracheobronchial system. This method also helps demonstrate the presence of fistulas in the tracheobronchial system or mediastinum. Using a neck or thorax CT, or a PET-CT distant metastases can be documented and a second tumour excluded. Imaging procedures gain additional significance for the evaluation of the T stage of the oesophageal tumour or the response to neoadjuvant therapy concepts, for which an earliest possible response evaluation is of great importance. Imaging procedures are also of importance in aftercare as it is sometimes possible and valuable to carry out surgery for local relapses.