Use of PET/CT to detect local and regional laryngeal cancer recurrence after surgery

Abstract

Background: Laryngeal cancer is the second most common cancer of the head and neck after cancer of the oral cavity. The primary causes of death in cases of laryngeal cancer are the recurrence of locoregional disease and distant metastasis. Anatomic and tissue alterations resulting from surgery and/or radiotherapy of primary laryngeal tumors can make it difficult to determine a locoregional recurrence or residual disease by physical examination or computed tomography (CT)/magnetic resonance imaging (MRI). The majority of studies have shown a high accuracy in the detection of local and regional recurrence of head and neck cancer after different treatment modalities, using fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. Aim: To determine the diagnostic accuracy of PET/CT in patients with suspicion of locoregional recurrence from laryngeal carcinoma after surgery with or without adjuvant radiotherapy. Materials and methods: This was a retrospective study. Forty-five patients who previously underwent surgical treatment with or without adjuvant radiotherapy for primary laryngeal squamous cell carcinoma and who underwent examination using FDG-PET/CT imaging after clinical and instrumental (CT/MRI) suspicion of locoregional recurrence (T or N) were recruited. Results: Overall specificity, sensitivity, and accuracy of PET/CT were found to be 88%, 100%, and 93.3%, respectively. With respect to the suspected cases of recurrence in the primary site, sensitivity, specificity, and accuracy of PET/CT were found to be 100%, 87.5%, and 91.6%, respectively. In patients with suspected metastatic neck disease, PET/CT revealed a sensitivity, specificity, and accuracy of 100%, 90%, and 95.4%, respectively. Conclusion: According to the results of this study, PET/CT imaging in laryngeal tumors is a useful tool in case of suspected locoregional recurrence where conventional imaging (CT and MRI) is unable to resolve the diagnostic doubt.

<p>Verbal performance of total laryngectomized patients rehabilitated with esophageal speech and tracheoesophageal speech: impacts on patient quality of life</p>

“…The main modalities of surgical treatment include transoral laser microsurgery, open preservation surgery, and total laryngectomy. In recent years, open preservation surgeries have increased,2,3 which can be attributed to the improvement of the preoperative staging and follow-up as a result of enhanced imaging approaches 4,5. The purpose of organ preservation surgery is to avoid the highly mutilating intervention of total laryngectomy and to maintain laryngeal function with respect to the oncological radicality.…”

The Role of 18-Fluoro-2-Deoxy-Glucose Positron Emission Tomography/Computed Tomography as Response and Prognosis Predictive Factor of Concurrent Chemoradiotherapy after Induction Chemotherapy in Head and Neck Squamous Cell Carcinoma: A Prospective Study

“…Several studies have already reported that due to high 18 F-FDG uptake in HNSCC it is possible to detect and differentiate metabolically active tumor cells among post-therapy changes [ 17 , 20 , 21 ]. Allegra et al in their study had revealed a specificity, sensitivity and accuracy of PET/CT of 100%, 90% and 95.4% respectively, in patients with suspected metastatic disease [ 22 ]. Also, it has been noticed that changes of tumor metabolic activity as a reaction to ICT appear earlier than morphological changes [ 17 , 20 ].…”

Diagnostic efficacy of positron emission computerized tomography scans in suspicious laryngeal findings postorgan preservation treatment

“…3 18 Fluoro-deoxy-glucose positron emission computerized tomography (PET-CT) imaging in laryngeal tumors has been proven to be a useful tool in identifying local recurrence as well as regional and distant metastasis. 4 However, interpretation of PET-CT scans may be inaccurate and consequently lead to unnecessary biopsies. 5 The best approach to follow-up patients completing larynx-preserving treatment protocols for laryngeal cancer with regard to unclear or suspicious findings on physical examination continues to be a matter of controversy.…”