After a confirmed diagnosis of esophageal cancer by endoscopy, which imaging study is used to evaluate for metastases?

• A. CT scan of the thorax
• B. Chest X-ray
• C. MRI of the brain
• D. Positron emission tomography

Answer: (A)

After confirming esophageal cancer, determining whether the disease has spread is essential for deciding treatment. A contrast-enhanced CT scan of the chest provides detailed cross-sectional images of the lungs, pleura, mediastinal and hilar lymph nodes, and surrounding structures. This helps identify metastatic deposits in the thoracic region and assesses nodal involvement, which are common considerations in staging. It offers superior sensitivity for detecting chest metastases compared with a chest X-ray, and it supplies precise anatomic information that can guide therapy planning. While brain MRI and whole-body PET-CT can be useful in specific scenarios, a chest CT is a practical, widely available test that efficiently evaluates for thoracic metastases as part of initial staging. If broader metastasis screening is needed later, imaging of the abdomen or PET-CT may be added.