Diagnoses Disease Clinical Trial
Official title:
Prospective Evaluation of MRI in Pre-operative Staging of Esophagus Cancers
The role of MRI in the management of esophageal cancer remains unclear and poorly studied.
Recent technical advances suggest that MRI may become a powerful technique for the initial
assessment of esophageal cancer, but also for the evaluation of response to neo-adjuvant
treatment before surgery.
This imaging study will be performed prospectively and consecutively in 60 patients included
over a 18-month period in patients wîth newly diagnosed esophageal cancer.
The aim of this study is to assess the accuracy of MRI to visualize esophageal tumors, to
assess tumor burden and potential contact with adjacent structures as well as associated
lymph nodes. If chemotherapy or radio-chemotherapy treatment is indicated before surgery, we
will also evaluate whether MRI helps us to better evaluate the response to this treatment in
comparison to PET-scan or echo. endoscopy which are the examinations currently performed to
evaluate the effectiveness of these treatments.
The images of the MRI exams will be interpreted by 1 expert radiologist with no knowledge of
the other imaging modalities and transmitted to the doctors in charge for possible
consideration for the treatment.
Patients will then be followed for one year according to clinical management standards to
study the data on treatment complications and cancer progression at one year.
The main risk is the administration of a gadolinium chelate-based MRI contrast product used
routinely. There is also a risk that the results of the MRI may influence the treatment
initially planned for example by canceling a surgical procedure.
The study will be proppsed consecutively to all patients with a histologically proven
diagnosis of esophageal cancer.
An MRI examination including morphological sequences (without and with injection of a
gadolinium chelate) functional and dynamic will be carried out in all the patients for
initial staging in addition to other diagnostic procedure performed in clinical routine in
this indication that are the endo-ultrasonography, CT and PET scanner.
In patients for whom neo-adjuvant treatment with chemotherapy or radio-chemotherapy will be
decided and started, a second MRI will be performed 4 to 6 weeks after the end of the
neo-adjuvant treatment.
The images of the MR exams will be interpreted by 1 expert radiologist blinded from data of
other imaging modalities and transmitted to the doctors in charge of the patient for possible
consideration for the treatment.
Patients will then be followed for one year according to regular recommandation to assess
mortality / morbidity and PFS at 1 year.
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