If you suspect esophageal cancer, imaging is essential, especially CT, but many people who have had a plain CT are asked to have an enhanced CT, so what is the difference between these two types of CT?
The cross-sectional imaging of an esophageal CT scan can show more accurately the extent of tumor invasion of the esophageal wall and surrounding tissues, as well as the enlarged lymph nodes in the esophagus and mediastinum, which can be useful for TNM staging of esophageal cancer and thus determining the likelihood of tumor resection.
CT is also an important tool for post-operative follow-up, and for evaluating outcomes after radiotherapy.
CT is divided into plain CT, which is a plain scan without contrast enhancement, and enhanced CT, which is a scan followed by a water-soluble organic iodine agent injected intravenously with a high-pressure syringe.
Plain CT has some false positives in differentiating esophageal lesions from aorta, pericardium, and prevertebral soft tissue. This means that a plain CT may “misdiagnose” a tumor when it is not esophageal cancer, resulting in a “false positive” that may make you receive unnecessary treatment.
Enhanced CT can significantly enhance the image of the aorta, allowing better differentiation. And, by “enhanced,” I mean that the enhancer is injected before the CT scan, so you won’t get a higher dose of radiation.