Esophageal MRI

Last revised by Andrew Murphy on 23 Mar 2023

Esophageal MRI, or gastro-esophageal junction (GEJ) MRI, is a targeted mediastinal imaging protocol performed to stage and aid treatment decisions in esophageal and GEJ carcinoma. It is not yet included in major treatment guidelines, but recent literature have pointed promising accuracy compared to other imaging modality 1-5.

Note: This article is intended to outline some general principles of protocol design. The specifics will vary depending on MRI hardware and software, radiologist's and referrer's preference, institutional protocols, patient factors, and time constraints.


A good protocol for this purpose usually requires cardiac and respiratory gating and involves at least:

  • T2 weighted

    • plane: axial, sagittal, and coronal

    • sequence: turbo spin-echo

    • purpose: tumor delineation and invasiveness across muscularis propria (stating)

  • T1 weighted

    • plane: axial

    • sequence: fast spoiled gradient echo (eg. LAVA, VIBE)

    • purpose: anatomical overview

  • diffusion-weighted imaging (DWI)

    • plane: axial

    • sequence: DWI: B=0, B=600 (some studies suggest B=800) and ADC 

    • purpose: evaluation of the tumor cellularity and response to treatment

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