Endoscopic ultrasound is the most accurate tool for staging esophageal cancer locally - depth of wall invasion (T) and locoregional nodes (N), ideally with FNA.

• Chest/abdominal CT (with PET) is used to detect distant metastases and gross local invasion, but it is less accurate than EUS for T and N staging.
• Barium studies and MRI are not the staging test of choice.