Effectiveness of ultrasonography and computed tomography in assessing thyroid cartilage invasion in laryngeal and hypopharyngeal cancers

Dhoot, Nilu Malpani; Choudhury, Binoy Kumar; Kataki, Amal C.; Kakoti, Lopa Mudra; Ahmed, Syed Adeel; Sharma, Jagannath Dev

doi:10.1007/s40477-017-0259-0

Cited by 10 publications

(13 citation statements)

References 25 publications

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“…A statistically significant improvement in the specificity of detection of paraglottic space invasion was seen with ultrasound. Dhoot et al performed a similar study but with pathological confirmation of thyroid cartilage invasion post-laryngectomy (24). A trend towards improved sensitivity in detection of thyroid cartilage invasion was also noted for ultrasound (98%) compared to CT (91%).…”

Section: Conventional Radiotherapymentioning

confidence: 88%

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Early-Stage Glottic Squamous Cell Carcinoma in the Era of Image-Guided Radiotherapy

et al. 2021

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Early-stage squamous cell cancer (SCC) of the glottis has a good prognosis. Therefore, patients have long survival outcomes and may potentially suffer from late toxicities of radiotherapy. Radiotherapy with a conventional parallel-opposed-pair or anterior-oblique beam arrangements for stage 1 and 2 glottic SCC have field borders that traditionally cover the entire larynx, exposing organs-at-risk (e.g. carotid arteries, contralateral vocal cord, contralateral arytenoid and inferior pharyngeal constrictor muscles) to high radiation doses. The potential long-term risk of cerebrovascular events has attracted much attention to the dose that carotid arteries receive. Swallow and respiratory motion of laryngeal structures has been an important factor that previously limited reduction of the radiation treatment volume. Motion has been evaluated using multiple imaging modalities and this information has been used to calculate PTV margins for generation of more limited target volumes. This review discusses the current literature surrounding dose-effect relationships for various organs-at-risk and the late toxicities that are associated with them. This article also reviews the currently available data and effects of laryngeal motions on dosimetry to the primary target. We also review the current limitations and benefits of a more targeted approach of radiotherapy for early-stage glottic SCCs and the evolution of CT-based IGRT and MR-guided radiotherapy techniques that may facilitate a shift away from a conventional 3D-conformal radiotherapy approach.

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Section: Conventional Radiotherapymentioning

confidence: 88%

“…Dhoot et al. performed a similar study but with pathological confirmation of thyroid cartilage invasion post-laryngectomy ( 24 ). A trend towards improved sensitivity in detection of thyroid cartilage invasion was also noted for ultrasound (98%) compared to CT (91%).…”

Section: Conventional Radiotherapymentioning

confidence: 99%

Early-Stage Glottic Squamous Cell Carcinoma in the Era of Image-Guided Radiotherapy

et al. 2021

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“…Further experience with the TLUSG examination can pave the way for new prospects of laryngeal ultrasound use in ENT Departments like the ultrasound-guided identification of the cricothyroid membrane in the management of cricothyrotomy [ 20 , 21 ], the assessment of laryngeal pathologies in children including dysphonia and stridor [ 22 ] or a diagnostic complement to laryngoscopy and tomography in patients with laryngeal cancer [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous laryngeal ultrasonography: A promising tool for otolaryngologists during COVID-19

Sciancalepore

Anzivino²,

Petrone³

et al. 2021

American Journal of Otolaryngology

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Purpose With the current COVID-19 outbreak, otolaryngologists are most exposed to the risk of infection due to the nature of the specialty.This is why they are required to find safer diagnostic alternatives minimizing aerosol-generating procedures. The aim of this study is to explore the accuracy of transcutaneous laryngeal ultrasonography (TLUSG) in order to assess vocal fold movement. Materials and methods We performed blindly both TLUSG and flexible fiberoptic laryngoscopy(FFL) on 38 patients, from March to June 2020. Patients were divided into two groups:the former with normally mobile vocal folds and the latter with unilateral vocal fold paralysis. Results On FFL findings, 10/38 patients (26,31%) had unilateral vocal fold paralysis; on TLUSG results, 9/38 patients (23.68%) presented impaired vocal fold motion. In comparison to laryngoscopy, the sensitivity, specificity, positive predictive value and negative predictive value of TLUSG for assessment of vocal fold mobility was 80%, 96.42%, 88.88%, 93.10% respectively. A significant association between the two techniques was found on the Chi-square test: X 2 = 19.7722 ( p value <0.00001). Cohen's K value showed a substantial agreement: K = 0,79. Conclusion Although TLUSG could undoubtedly not replace laringoscopy, it represents a noninvasive and useful diagnostic tool for otolaryngologists especially during covid-19 pandemic.Data collected about its high sensitivity and specificity suggest that TLUSG could be a reliable method to screen vocal fold paralysis without performing aerosol-generating procedures, thus providing clear visualization of laryngeal real-time movements, even in non-compliant or high-risk infection patients. Our results allow us to consider TLUSG as part of the preoperative assessment of vocal folds in patients undergoing thyroidectomy.

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“…Notably, other studies even reported higher diagnostic accuracy of CT for detection of thyroid cartilage invasion. Dhoot et al, [14] evaluated the adequacy of CT in the assessment of thyroid cartilage invasion in patients with airway cancer. Sixtytwo consecutive patients underwent CT to stage laryngeal (n=27) or hypopharyngeal (n=35) cancer in this prospective study.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study between CT and MRI in Assessment of Laryngeal Cartilage Invasion in Laryngeal Carcinoma

Elkholy¹,

Kandeel

Asaad

2021

The Medical Journal of Cairo University

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Background: Laryngeal cancer comprises 2 to 5% of all malignant diseases diagnosed annually worldwide. Cartilage invasion by the laryngeal cancer is of great importance through the staging of laryngeal carcinoma according to TNM classification and has a great impact on management plan. There is a scarcity in the published literature regarding the comparison between MRI and CT for assessment of cartilage involvement. Aim of Study:To assess the validity of MRI and to compare this with CT findings in predicting inner and outer thyroid cartilage laminae invasion in patients with laryngeal carcinoma.Patients and Methods: The present study was an observational analytical study that was carried out from January 2018 to June 2019 at the Radiology Department of Faculty of Medicine, Cairo University. A total of 30 patients with laryngeal carcinoma were included. CT and MRI was done for all patients.Results: There was a good agreement between readers in CT interpretation in term of inner lamina involvement (K=0.78) and very good agreement in term of outer lamina involvement (K=0.87). While in MRI interpretation, there was a very good agreement between readers in term of inner lamina involvement (K=0.83) and outer lamina involvement (K=0.92). However higher accuracy & confidence levels were found on interpretation of both CT and MRI together. We found a higher interobserver agreement between interpretation of CT and MRI together (K=1.00). Conclusion:MRI showed high validity and precision in detecting inner and outer thyroid lamina invasion by laryngeal caner than CT scan. We found that the combination of CT and MRI together was associated with more accuracy and confidence level for the readers.

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Effectiveness of ultrasonography and computed tomography in assessing thyroid cartilage invasion in laryngeal and hypopharyngeal cancers

Cited by 10 publications

References 25 publications

Early-Stage Glottic Squamous Cell Carcinoma in the Era of Image-Guided Radiotherapy

Early-Stage Glottic Squamous Cell Carcinoma in the Era of Image-Guided Radiotherapy

Transcutaneous laryngeal ultrasonography: A promising tool for otolaryngologists during COVID-19

Comparative Study between CT and MRI in Assessment of Laryngeal Cartilage Invasion in Laryngeal Carcinoma

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