{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:09:00Z","timestamp":1780484940232,"version":"3.54.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To validate a standardized MRI scoring system, tracheal invasion score (T-score) and vascular invasion score (V-score) against CT for detecting tracheal and major-vessel invasion in esophageal cancer, based on imaging obtained after neoadjuvant therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      Twenty-six patients (mean age 65\u2009years) who underwent both MRI and CT after preoperative therapy and prior to esophagectomy were retrospectively reviewed. Two radiologists independently assigned T- and V-scores on MRI and CT-based T-stage (12th Japanese Classification). Diagnostic performance was measured by the area under the ROC curve (AUC) and\n                      <jats:italic>\u03ba<\/jats:italic>\n                      for inter-reader agreement. Patient-level bootstrap resampling (2000 iterations) compared the combined MRI score\u2014defined as max (T, V)\u2014with CT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      MRI yielded higher AUCs than CT for tracheal invasion (0.943\u20130.990 vs. 0.529\u20130.706) and vascular invasion (0.878 for both readers). MRI achieved substantial-to-almost-perfect agreement (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.771\u20131.000), whereas CT was only moderate (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.369\u20130.487). Bootstrap analysis confirmed superior discrimination of the combined MRI score: \u0394AUC\u2009+\u20090.19 (\u20130.05\u20130.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.11) for Reader A and +0.38 (0.07\u20130.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) for Reader B.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A combined MRI T\/V-score provides better accuracy and inter-reader reliability than CT for evaluating critical local invasion, even after preoperative therapy, supporting routine integration of MRI when CT findings are equivocal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Determine whether a standardized MRI scoring system for tracheal and vascular invasion improves diagnostic accuracy compared with contrast\u2011enhanced CT in esophageal cancer.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>MRI outperforms CT in detecting tracheal and vascular invasion, with higher specificity and superior inter-reader agreement using standardized scoring criteria.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Standardized MRI scoring improves staging accuracy in suspected T4 esophageal cancer, aiding surgical decision-making and helping to avoid unnecessary surgery in inoperable patients as well as incomplete (R1\/R2) resections<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-12080-4","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T10:19:54Z","timestamp":1761387594000},"page":"2842-2850","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["MRI outperforms CT for tracheal and vascular invasion staging in esophageal cancer"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7977-0272","authenticated-orcid":false,"given":"Yumiko","family":"Kono","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Harino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Ogasawara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohiro","family":"Akita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Yamasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noboru","family":"Tanigawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"12080_CR1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-86244-z","volume":"15","author":"L Sun","year":"2025","unstructured":"Sun L, Zhao K, Liu X, Meng X (2025) Global, regional, and national burden of esophageal cancer using the 2019 global burden of disease study. 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No additional complex statistical methods were required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The study cohort has not been previously reported.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}