1 Comparison of Esophagography and Chest Computed Tomography and the Prognostic Value of Inflammatory Markers for Detecting Anastomotic Leakage After Esophageal Resection https://brieflands.com/journals/amhsr/articles/156851 10.69107/amh-156851 1 Background :Esophageal cancer poses substantial treatment challenges, particularly when esophagectomy is required. Despite advances in multimodality therapy, esophagectomy remains the primary curative approach. Anastomotic leakage (AL) after esophagectomy is associated with mortality rates of up to 40%–60%. Therefore, timely detection and intervention are essential to mitigate adverse outcomes. Objectives :This study aimed to identify the gold standard for assessing AL after esophageal resection. Methods :This prospective study was conducted at Imam Khomeini Complex Hospital, Tehran, Iran. From May to December 2022, a total of 46 patients who underwent esophageal or gastric resection for cancer were enrolled. Patients were evaluated using esophagography, chest computed tomography (CT), C-reactive protein (CRP) levels on postoperative days (within 30 days, as the gold standard of care), and clinical signs. Thirty patients underwent postoperative radiographic examination using a water-soluble contrast medium, and 16 underwent chest CT with oral and intravenous contrast medium during the same period. CRP levels were measured in all patients on the day of esophagography or chest CT. Results :Ten patients exhibited clinical signs of leakage. Among the 30 patients who underwent radiographic examination, 27 (90%) had normal findings and 3 (10%) had AL, whereas clinical signs of AL were present in 10 patients (33.3%). Among the 16 patients who underwent chest CT, 9 (56.3%) had normal findings and 7 (43.8%) had AL. The sensitivity, specificity, and accuracy of radiographic examination were 30%, 100%, and 71.43%, respectively, compared with 71.43%, 66.67%, and 68.75%, respectively, for chest CT. The chi-square test showed no association between CRP levels and clinical signs of leakage (P = 0.771). Conclusions :Esophagography demonstrated lower sensitivity than CT, although its accuracy was higher, indicating that both methods can be used to evaluate patients with clinical signs of AL. C-reactive protein levels were not associated with AL. 1 7 Seyed Hosein Mirjavadi Department of Cancer Radiology, Imam Khomeini Complex Hospital, Tehran University of Medical Scinece, Tehran, Iran Iran mirjavadihosein@gmail.com Mohadese Estaji Department of Medical Physics and Biomedical, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Iran mestaji@yahoo.com Soheila Koopaee Department of Cancer Radiology, Imam Khomeini Complex Hospital, Tehran University of Medical Scinece, Tehran, Iran Iran skoopaee@gmail.com Farideh Pak Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, California, USA USA farideh.pak@cshs.org Amirmohsen Jalaeefar Department of Surgical Oncology, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran Iran jalaeefar@gmail.com Elahe Jazayeri Gharehbagh Department of Radiation Twchnology, Faculty of Allied Medicine, Tehran University of Medical Science, Tehran, Iran Iran ejazayeri@sina.tums.ac.ir No Keyword 1.pdf [0]Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al.Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. 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