Background: This study was performed to evaluate whether pre-treatment contrast-enhanced CT (CECT) images have predictive information about esophageal stricture after chemoradiation therapy (CRT) for esophageal squamous cell carcinoma (SCC).
Methods: This retrospective study was performed with institutional review board approval. Nineteen patients with advanced esophageal SCC who underwent CRT at our institution from February 2006 to July 2014 were selected for this study. Eight of the 19 patients (42.1%) developed esophageal stricture after CRT. In each patient, a three-dimensional data set was created from the pre-treatment CECT images, and the esophageal lesion was delineated as one structure. Volumetric and texture analyses were performed for each structure. The mean and standard deviation (SD) of CT number was examined in texture analyses.
Results: On volumetric analysis, there was no difference in the mean volume of the esophageal lesion between the patients with and without stricture (15.1 vs. 14.7 mL, respectively, P=0.9435). On texture analyses, there was no difference between in the mean value of mean CT number between the patients with and without stricture (74.8 vs. 74.2 HU, respectively, P=0.9326). On the other hand, the mean value of SD of CT number in the patients with stricture was significantly greater than that in the patients without stricture (24.8 vs. 19.5 HU, respectively, P=0.0221).
Conclusion: The SD of CT number (i.e., texture irregularity) in esophageal lesions in pre-treatment CECT could be a predictive factor for development of esophageal stricture after CRT for esophageal SCC.
Keywords: Chemoradiation therapy, esophageal stricture, texture analysis, predictive factor