The Role of Magnetic Resonance Imaging in the Management of Esophageal Cancer

SIMPLE SUMMARY: Esophageal cancer (EC) is the eighth most frequent cancer worldwide, with a poor prognosis. Current imaging modalities for staging and follow-up mainly include computed tomography (CT), positron emission tomography (PET)/CT, and endoscopic ultrasound. Magnetic resonance imaging (MRI), which is a non-irradiating and non-invasive modality, can provide identification of the esophageal wall and esophagogastric junction. MRI has shown encouraging capabilities in regional and local staging of EC as well as in the assessment of treatment response to therapy. Technical refinements in MRI technique and sequences overtime have contributed to its increasing diagnostic performance as well as its generalizability. MRI could become a routine imaging technique for EC management in the future, alone or in combination with other modalities. ABSTRACT: Esophageal cancer (EC) is the eighth more frequent cancer worldwide, with a poor prognosis. Initial staging is critical to decide on the best individual treatment approach. Current modalities for the assessment of EC are irradiating techniques, such as computed tomography (CT) and positron emission tomography/CT, or invasive techniques, such as digestive endoscopy and endoscopic ultrasound. Magnetic resonance imaging (MRI) is a non-invasive and non-irradiating imaging technique that provides high degrees of soft tissue contrast, with good depiction of the esophageal wall and the esophagogastric junction. Various sequences of MRI have shown good performance in initial tumor and lymph node staging in EC. Diffusion-weighted MRI has also demonstrated capabilities in the evaluation of tumor response to chemoradiotherapy. To date, there is not enough data to consider whole body MRI as a routine investigation for the detection of initial metastases or for prediction of distant recurrence. This narrative review summarizes the current knowledge on MRI for the management of EC.