Evidence map›Paper›PMID 40379940›Full record

ArticleEuropean radiology2025

Evaluation of MRI for initial staging of esophageal cancer: the STIRMCO study.

Vincent Levy, Mario Jreige, Laura Haefliger, Celine Du Pasquier, Camille Noirot, Anna Dorothea Wagner, Styliani Mantziari, Markus Schäfer, Naik Vietti-Violi, Clarisse Dromain

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Vincent LevyDepartment of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Mario JreigeDepartment of Nuclear Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Laura HaefligerDepartment of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Celine Du PasquierDepartment of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Camille NoirotDepartment of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Anna Dorothea WagnerDepartment of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Styliani MantziariDepartment of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Markus SchäferDepartment of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Naik Vietti-VioliDepartment of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Clarisse DromainDepartment of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Clarisse.Dromain@chuv.ch.ORCID http://orcid.org/0000-0002-2999-1958

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare the diagnostic accuracy of MRI and PET/CT combined versus standard staging methods (CT, endoscopic ultrasound [EUS], and PET/CT) for initial staging of esophageal cancer (EC). MATERIALS AND

methodsThis study included patients newly diagnosed with histologically proven EC between 2017 and 2021. Patients underwent a 3-T esophageal MRI alongside standard staging (CT, EUS, PET/CT) prior to treatment. TNM-stages were assessed by two independent reviewers for MRI, CT, and PET/CT, with EUS evaluated by one operator. Discrepancies were resolved by a third reviewer. Patients were categorized based on treatment management: surgery (T1-T2N0M0), neoadjuvant (radio)chemotherapy (T3-T4a and/or N1-N2-N3M0), and palliative chemotherapy (T4b and/or M1). The reference standard was histopathology from surgical specimens or TNM staging from tumor board discussions. The area under the curve (AUC) was calculated for each imaging combination.

results60 patients newly diagnosed with EC (50M/10F; mean age 66.5 years) were prospectively enrolled. MRI + PET/CT combination exhibited the highest AUC (0.92, 95% CI: 0.79-1) for differentiating curative versus palliative patients, without statistically significant difference compared to CT + EUS (0.80, 95% CI: 0.56-1, p = 0.34), CT + PET/CT (0.77, 95% CI: 0.53-1, p = 0.42), and CT + EUS + PET/CT (0.78, 95% CI: 0.58-0.97, p = 0.26). In term of differentiating patients eligible for upfront surgery from those with indication for neoadjuvant (radio)chemotherapy, the combination of CT + EUS + PET/CT demonstrated the highest AUC (0.90, 95% CI: 0.75-1) without statistically significant difference compared to CT + EUS (0.82, 95% CI: 0.56-1, p = 0.49), CT + PET/CT (0.79, 95% CI: 0.46-1, p = 0.36), and MRI + PET/CT (0.83, 95% CI: 0.65-1, p = 0.59).

conclusionMRI + PET/CT combination is highly accurate for initial EC staging and non-inferior to standard methods, offering less invasiveness and reduced radiation exposure. KEY POINTS: Question Can MRI help improve the TNM staging of esophageal cancer? Findings MRI + PET/CT showed no statistically significant difference compared to endoscopic ultrasound (EUS) + CT + PET/CT in identifying curative vs palliative patients but with a tendency for improved staging. Clinical relevance Thoraco-abdominal MRI can provide added value (as a replacement of CT and EUS) in initial staging of esophagus cancer, particularly in cases of stenotic or advanced tumors.

Indexed as

Esophageal NeoplasmsMagnetic Resonance ImagingAgedEndosonographyFemaleHumansMaleMiddle AgedNeoplasm StagingPositron Emission Tomography Computed TomographyProspective StudiesSensitivity and SpecificityEsophageal neoplasmsMagnetic resonance imagingNeoplasm staging

Identifiers

PMID40379940
PMCPMC12559062

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.