Laryngeal cancer: how does the radiologist help?

Connor, Steve

doi:10.1102/1470-7330.2007.0010

Cited by 59 publications

(51 citation statements)

References 22 publications

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“…Several studies, reported sensitivity of 100% for MRI examination in detection of preepiglottic space infiltration, and specificity of 85%. Sensitivity of MRI was lower in our study (91%) while specificity was shown to be better than in the previous reports (96%) [9,10]. If endoscopy with biopsy is being performed on a tumor primary localized in submucosa, inflammation could be seen in the surrounding tissue [11].…”

Section: Discussioncontrasting

confidence: 77%

Diagnostic significance of magnetic resonance imaging in preoperative evaluation of patients with laryngeal tumors

Banko

Dukić

Milovanović

et al. 2011

Eur Arch Otorhinolaryngol

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To evaluate the diagnostic accuracy of pretreatment surgical magnetic resonance images (MRI) in the assessment of patients with laryngeal tumors. The prospective study included 34 patients (mean age 62.2 ± 5.1 years) with suspected tumors of the larynx who underwent laryngeal endoscopy, followed by MRI. The MRI images were evaluated for the invasion of anterior commissure, subglottis, paraglottic and preepiglotic space, cartilage invasion, extension to extralaryngeal tissue and lymph nodes, and were compared to pathological examination of surgical specimen. In 15 patients (44%) the tumor was glottic, in 10 patients (29%) supraglottic, in 9 (27%) patients tumor was transglottic. No statistical difference was seen in the number of patients with positive MRI findings in comparison to postsurgical pathohistology for extension to subglottic subside (29 vs. 38%), growth to the anterior commissure (48 vs. 48%), preepiglottic space (33 vs. 29%), and cartilage infiltration (19 vs. 14%), respectively. However, infiltration of the paraglottic spaces was observed more frequently on MRI (71 vs. 47%), p < 0.05. According to MR findings, 4 (12%) patients were classified as T2, 26 (76%) patients as T3 and 4 (12%) patients as T4, while on pathohystological specimens after surgery, 12 patients were classified as T2 (35%), 18 as T3 (53%), and 4 as T4 (12%). Based on MRI, 76% of the patients were correctly classified, which was shown to be statistically significant (ρ = 0.56, <0.05). Fifteen patients had metastases in regional lymph nodes and only two were detected on MRI. MRI has been shown to be a method that contributes to presurgical assessment of patients with tumor of the larynx.

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Section: Discussioncontrasting

confidence: 77%

Diagnostic significance of magnetic resonance imaging in preoperative evaluation of patients with laryngeal tumors

Banko

Dukić

Milovanović

et al. 2011

Eur Arch Otorhinolaryngol

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“…It gives the opportunity to assess laryngeal cartilages and extralarygeal invasion, enables examination of paraglottic and preepiglottic areas that cannot be examined directly by VLS and shows subglottic invasion more clearly than VLS. 9 However, it is not possible to determine vocal cord mobility by CT. VLS provides the opportunity to visualize the lesion directly. Furthermore, by means of stroboscopic examination, mucosal vibration can be examined and early stage larynx cancers can be determined.…”

Section: Discussionmentioning

confidence: 99%

“…It may also better define the margin between the tumor and thyroarytenoid muscle and involvement of the tongue base. 9 In recent years, ultrasound and fluorodeoxyglucose (FDG) positron emission tomography (PET) have been other methods used for the evaluation of larynx. Although ultrasound may be used to visualize the anterior laryngeal structures, it is not sufficient for adequate Tatlıpınar ve ark.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Videolaryngostroboscopy and Computed Tomography Findings with Histopathological Results in Larynx Cancers

Tatlipinar¹,

Dursun²,

Sak³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study was to investigate which diagnostic method was more efficient and reliable for preoperative T staging of laryngeal cancers by comparing videolaryngostroboscopy (VLS) and computed tomography (CT) findings with histopathologic examination of operation specimens. The main goal was to determine the most rational and accurate approach for preoperative evaluation and staging of larynx cancers. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This retrospective study included 58 patients operated on for larynx cancer. Preoperative VLS and CT findings were compared with histopathologic examination results of the operation specimens. The larynx was divided into 12 anatomical areas for this purpose. In addition, thyroid and cricoid cartilage invasion and extralaryngeal invasion parameters were included in the evaluation. Invasion of the tumor was identified by each evaluation method separately. Mobility of the vocal cords and arytenoids was evaluated with VLS. R Re es su ul lt ts s: : CT was more effective than VLS in the evaluation of the paraglottic area, preepiglottic area, and subglottic area. CT was superior to VLS for the identification of thyroid involvement, cricoid cartilages and extralaryngeal invasion. VLS was more effective than CT for the assessment of the vocal cords and anterior commissure. Both diagnostic methods were effective for identification of tumor on the epiglottis. C Co on nc cl lu us si io on n: : Success of VLS and CT changes according to the involvement of different anatomic areas. A combination of VLS and CT together, while taking into consideration the location of the tumor, improves accurate staging and consequently the surgical success.K Ke ey y W Wo or rd ds s: : Laryngeal neoplasms; tomography, X-ray computed Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, videolarengostroboskopi (VLS) ve bilgisayarlı tomografi (BT) bulgularını, operasyon materyallerinin histopatolojik değerlendirme sonuçlarıyla karşılaştırarak, larenks kanserlerinin preoperatif T evrelemesi için hangi tanısal yöntemin daha etkili ve güvenilir olduğunu araştırmaktı. Ana hedef, larenks kanserlerinin evrelemesi ve preoperatif değerlendirmesi için en akılcı ve doğru yaklaşımı saptamaktı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu prospektif çalışmaya larenks kanseri nedeniyle opere edilmiş 58 hasta dahil edildi. Preoperatif VLS ve BT bulguları, operasyon materyallerinin histopatolojik değerlendirme sonuçlarıyla karşılaştırıldı. Bu amaçla larenks 12 anatomik alana ayrıldı. Ek olarak tiroit ve krikoid kıkırdak invazyonu ve ekstralarengeal invazyon parametreleri değerlendirmeye dahil edildi. Tümör invazyonu her değerlendirme yöntemi ile ayrı ayrı tanımlandı. Vokal kordların ve aritenoidlerin mobilitesi VLS ile değerlendirildi. B Bu ul lg gu ul la ar r: : BT paraglotik alan, preepiglotik alan ve subglotik alan değerlendirmesinde VLS'den daha etkili bulundu. Tiroit ve krikoid kıkırdakların tutulumu ve ekstralarengeal invazyonu...

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“…New criteria of moderately high T2-w signal and moderate enhancement as compared to the marked signal changes and gadolinium enhancement with inflammation, have been proposed to overcome this problem. Alternatively the lower specificity of MRI may be addressed by performing a corroborating CT scan in the presence of an MRI scan positive for cartilage invasion (245). The introduction of multi-slice CT has resulted in an increase of spatial and temporal resolution but has led to little progress in interpretation of cartilage invasion which is still sometimes overestimated.…”

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confidence: 99%

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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Laryngeal cancer: how does the radiologist help?

Cited by 59 publications

References 22 publications

Diagnostic significance of magnetic resonance imaging in preoperative evaluation of patients with laryngeal tumors

Diagnostic significance of magnetic resonance imaging in preoperative evaluation of patients with laryngeal tumors

Comparison of Videolaryngostroboscopy and Computed Tomography Findings with Histopathological Results in Larynx Cancers

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

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