Aim: To compare multi-detector CT esophagography (MDCTE) in patients of esophageal carcinoma with barium swallow and upper gastrointestinal endoscopy.

Materials and Methods: Seventy patients (44 males; mean age 55.1 years) of esophageal carcinoma were included in the study after informed consent. After an upper gastrointestinal endoscopy and biopsy, MDCTE and barium swallow study were performed on the same day. MDCTE was performed by manual  instillation of room air via a nasogastric tube (NGT) inserted into the hypopharynx, and patient comfort assessed on a three-point scale. The MDCTE images were evaluated for the degree of distension and diagnostic quality. Kappa weighted analysis assessed concordance between MDCTE and conventional imaging (barium swallow and endoscopy).

Results: In 68 (97%) patients, MDCTE was considered tolerable. Good or fair esophageal distension and diagnostic quality MDCTE study were achieved in 63 (90%) patients. The agreement between conventional studies (barium swallow and endoscopy) and MDCTE for the presence of lesion and lesion morphology was 91.3% and 63%, respectively.

Conclusion: MDCTE provides diagnostic quality images with adequate distension of esophagus and better lesion definition in most patients without significant discomfort.