Diffusion-weighted imaging and diffusion-weighted whole-body imaging with background body signal suppression for characterizing esophageal cancer: a case report

Minoru Tomizawa,¹ Fuminobu Shinozaki,² Aika Ozaki,² Akira Baba,² Yoshiya Fukamizu,² Futoshi Matsunaga,² Takao Sugiyama,³ Shigenori Yamamoto,⁴ Makoto Sueishi,³ Takanobu Yoshida<sup>5

1</sup>Department of Gastroenterology, ²Department of Radiology, ³Department of Rheumatology, ⁴Department of Pediatrics, ⁵Department of Internal Medicine, National Hospital Organization Shimoshizu Hospital, Yotsukaido City, Japan

Purpose: Information on the extent or structure of esophageal cancer (ESC) is necessary for identifying whether the carcinoma is localized or resectable. Diffusion-weighted imaging (DWI) and diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) are useful for this purpose.
Patients and methods: One case of ESC with dysphagia presented at our hospital. Endoscopic examination revealed an elevated lesion with an ulcer, and stenosis was detected. DWI showed a high-intensity signal extending from the proximal to the distal ends of the carcinoma and extending to the tunica adventitia. A strong signal was also observed using ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET). DWIBS clearly revealed ESC, and these findings, along with those from DWI, suggested that our case had stage-T3 ESC. FDG-PET did not reveal the detailed structure of the ESC. DWIBS, on the other hand, showed that the signal extended to the tunica adventitia and the lumen of the esophagus.
Conclusion: These findings suggest that DWI and DWIBS are useful for the detection and assessment of ESC.

Keywords: positron emission tomography, endoscopy, computed tomography, cross section, squamous cell carcinoma