Fluorodeoxyglucose‐Positron Emission Tomography/Computed Tomography Imaging in Patients with Carcinoma of the Larynx: Diagnostic Accuracy and Impact on Clinical Management

Gordin, Arie; Daitzchman, Marcelo; Doweck, Ilana; Yefremov, Nikolay; Golz, Avishay; Keidar, Zohar; Bar‐Shalom, Rachel; Kuten, Abraham; Israel, Ora

doi:10.1097/01.mlg.0000197930.93582.32

Cited by 72 publications

(48 citation statements)

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“…We obtained from their combination a final 95% CI 0.51-0.88 for Se and a value of 95% CI 0.55-0.96 for Sp, reporting a very high I 2 value for both Se (87.7%) and Sp (95.91%), where the lowest rates of Se were reported by Hartl et al (220) and Allegra and colleagues (218), whilst Gordin and Beser (191,222) showed the lowest rate for Sp. Here the hypothesis of hegemony among these different studies was not statistically significant ( Figure 16).…”

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confidence: 85%

“…Two recent studies opened new directions for applying MRI for laryngeal imaging: MR microimaging of excised larynges confirmed valid high-resolution imaging of laryngeal tissue microstructure (189), and dynamic MRI of laryngeal and vocal fold vibrations was realized for the first time for measuring of laryngeal structures and glottal parameters in dynamic function (190). (191). PET is a functional imaging modality assessing the metabolic status of tumors and has proved superior to CT and MRI in differentiating recurrence from post-radiation effects or scar in patients with carcinoma of the larynx (191,192).…”

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confidence: 99%

“…(191). PET is a functional imaging modality assessing the metabolic status of tumors and has proved superior to CT and MRI in differentiating recurrence from post-radiation effects or scar in patients with carcinoma of the larynx (191,192). A negative PET scan excludes recurrence with a high certainty.…”

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confidence: 99%

“…We can see how different reports are in contradiction; for instance, Gordin et al (191) showed a CAT sensitivity in identifying cartilage involvement of 88%, with a very low specificity (8%); results that have been disproved by Allegra and colleagues (218) who found CAT values of 50% (sensitivity) and 100% (specificity), respectively for identification of cartilage invasion. Despite this conflicting final results, if we compare reports published before 2005 to the most recent works, we do not find any statistical significances among these two groups in terms of sensitivity (p=0.3367) and specificity (p=0.2574) for tumor cartilage involvement.…”

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confidence: 91%

“…In the 1990s' PET and CAT/PET entered into the clinical practice and Gordin et al (191) showed how the combination of CAT and PET can reach a better sensitivity and specificity in comparison to PET study by itself (92% and 96% vs. 92% and 73%, respectively).But, for the first time, Jeong et al (193) showed that PET/CT findings do not add to the conventional work-up for the initial evaluation of glottic cancer any further advantages that would support the additional cost of this exam. (230) is worthy to be mentioned because, even if it did not meet all of the inclusion criteria to be enrolled for our meta-analysis, it showed a high quality score of 7 and gave the image of the actual skyline about general ear-nose-throat (ENT) practice in the U.S.A. analyzing factors influencing the common clinical practice and how this could engrave patients management.…”

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confidence: 99%

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Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Mannelli

Cecconi

Gallo

2016

Critical Reviews in Oncology/Hematology

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Abstract.Background: Multi-step cancerogenesis guides laryngeal cancer onset and it includes a wide variety of pre-cancerous lesions that are macroscopically challenging to identify and distinguish from initial cancerous foci. Since the treatment of laryngeal cancer and its precursor lesions has a great impact on important laryngeal basic functions, early detection and preoperative assessment are important for a curative and function-preserving therapy. Nowadays, despite the high number of more advanced diagnostic techniques and methods, unfortunately, it is not uncommon for different clinicians to use different nomenclature or to identify different stage for the same laryngeal lesion. From these observations, it is obvious that an instrument offering the possibility to detect precancerous lesions, early cancerous lesions, and satellite foci or second primaries would be the key to improving management and outcome in laryngeal patients. Object. Different modalities of diagnostic techniques of laryngeal lesions exist. Rather than difference between benign and obvious malignant diseases, more difficult is to detect the presence of precancerous epithelial alterations. Not all tests achieve the same diagnostic accuracy, hence this meta-analysis of literature aimed to synthesize the validity of each single diagnostic technique in identifying and staging laryngeal disease. Methods: A systematic review of literature was led searching for articles mentioning the following terms including their various combinations to maximize the yield: larynx, laryngeal precancerous lesions, laryngeal cancer, white light (WL) endoscopy, stroboscopy, contact endoscopy (CE), autofluorescence (AF), ultrasound (US), narrow band imaging (NBI), computed axial tomography (CAT), magnetic resonance imaging (MRI), positron emission tomography (PET), CAT/PET. Then, a quantitative analysis was carried on for paper published after 2005 onward, reporting a minumun series of 10 patients each study, declaring sensitivity and specificity of each diagnostic system. Results: The search identified 7215 publications, of which 3616 published after 2005, with a final results of a total of 214 articles stratified and included by our selection criteria. 42 out of 214 articles were selected for quantitative synthesis. 25 out of 41 studies had a quality score of ≥ 6 (good), 16 presented a score between 4 and 5 (fair). While objections can be raised about the pooling of different diagnostic procedures under the same group and the high level of heterogeneity in the meta-analyses, the inclusion of over 4400 laryngeal lesions makes the results fairly robust. Conclusions: A comprehensive overview of the most recent advances in laryngeal imaging technology combined with all of the information needed to interpret findings and successfully manage patients with voice disorders can be found herein. With these data, clinicians can riskstratify patients and select proper examination modalities in order to provide appropriate care. Moreover, study limitations, together with p...

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confidence: 85%

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confidence: 99%

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confidence: 99%

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confidence: 91%

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confidence: 99%

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Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Mannelli

Cecconi

Gallo

2016

Critical Reviews in Oncology/Hematology

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Detection of Occult Bone Metastases From Head and Neck Squamous Cell Carcinoma

Basu

Siegel²,

McDonald³

et al. 2007

Arch Otolaryngol Head Neck Surg

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To assess the ability of positron emission tomography-computed tomography with fluorodeoxyglucose F 18 (FDG-PET/CT) to provide early, accurate detection of bone metastases from head and neck squamous cell carcinoma (HNSCC) and to determine the impact of detecting occult bone metastases on patient care.Design: Retrospective medical chart review.Setting: Single academic medical center. Patients:The study population comprised 13 patients with FDG-PET/CT scans detecting bone lesions suggestive of HNSCC metastases. These patients were identified from a retrospective review of 683 consecutive FDG-PET/CT scans performed for initial staging (n =198) or restaging (n=485) of HNSCC between October 2002 and December 2005.Main Outcome Measures: Rate of biopsy confirmation of bone lesions detected by FDG-PET/CT as suggestive of metastases, presence of concurrent symptoms or laboratory serologic evidence for bone metastasis, timing of bone metastasis detection relative to initial diag-nosis of HNSCC, and change in therapeutic decision making based on bone metastasis detection.Results: Eleven FDG-PET/CT studies that detected bone metastasis were performed to restage a suspected or known recurrence, and 2 studies were performed for radiographic restaging of disease after completion of therapy. Bone biopsy confirmation was performed in 5 patients, and 4 of the biopsy results were positive for metastatic HNSCC. All patients lacked clinical symptoms of bone involvement, and 82% (n=9) had serum alkaline phosphatase levels in the normal (n = 7) or minimally elevated (n=2) range. At the time of bone metastasis detection, 6 of the 12 patients (50%) had no other identifiable distant metastatic disease. Furthermore, 2 patients (17%) lacked disease at any other local, regional, or distant site. The identification of bone metastases influenced therapeutic decisions in 5 of 13 cases (38%). Conclusion:Use of FDG-PET/CT in restaging HNSCC allows for detection of occult bone metastases, and this early detection frequently influences therapeutic decision making.

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Identification of distant metastases with PET‐CT in patients with suspected recurrent head and neck cancer

Gourin

Watts²,

Williams³

et al. 2009

The Laryngoscope

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Fluorodeoxyglucose‐Positron Emission Tomography/Computed Tomography Imaging in Patients with Carcinoma of the Larynx: Diagnostic Accuracy and Impact on Clinical Management

Abstract: The performance of PET/CT is better than standalone PET or CT in patients with cancer of the larynx. PET/CT had a major impact on management of 59% of patients.

Cited by 72 publications

References 18 publications

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Detection of Occult Bone Metastases From Head and Neck Squamous Cell Carcinoma

Identification of distant metastases with PET‐CT in patients with suspected recurrent head and neck cancer

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