1
|
Comparison of CT and MRI in Diagnosis of Laryngeal Carcinoma with Anterior Vocal Commissure Involvement. Sci Rep 2016; 6:30353. [PMID: 27480073 PMCID: PMC4969597 DOI: 10.1038/srep30353] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 07/04/2016] [Indexed: 02/02/2023] Open
Abstract
This study aimed to compare the accuracy of CT and MRI in determining the invasion of thyroid cartilage by and the T staging of laryngeal carcinoma with anterior vocal commissure (AVC) involvement. A total of 26 cases of laryngeal carcinomas with AVC involvement from May 2012 to January 2014 underwent enhanced CT and MRI scan, out of whom 6 patients also underwent diffusion-weighted magnetic resonance imaging(DWI). T staging and thyroid cartilage involvement were evaluated. All the surgical specimens underwent serial section and were reviewed by two senior pathologists independently. When compared with pathologic staging, the accuracy was 88.46% (23/26) of MRI scan (with a 95% confidence interval 37~77%) and 57.69% (15/26) of CT scan (with a 95% confidence interval 70~98%), respectively (P < 0.01). We also reported three cases who were misdiagnosed on CT or MRI about either the thyroid cartilage was involved or not, and one case of preliminary study of DWI. Compared to CT, MRI exhibited a higher accuracy rate on T staging of laryngeal carcinomas with AVC involvement. Combined utility of CT and MRI could help improve the accuracy of assessment of thyroid cartilage involvement and T staging of laryngeal carcinomas with AVC involvement.
Collapse
|
2
|
Koopmann M, Weiss D, Steiger M, Elges S, Rudack C, Stenner M. Thyroid cartilage invasion in laryngeal and hypopharyngeal squamous cell carcinoma treated with total laryngectomy. Eur Arch Otorhinolaryngol 2016; 273:3789-3794. [PMID: 27256366 DOI: 10.1007/s00405-016-4120-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/27/2016] [Indexed: 11/24/2022]
Abstract
The objective of this study is to analyze the accuracy of computed tomography in detecting malignant thyroid cartilage invasion. In a retrospective chart review, 120 patients with carcinoma of the larynx and hypopharynx underwent computed tomography before total laryngectomy. These data were compared with the histological specimens. Multidetector computed tomography (MDCT) scan had a positive predictive value (PPV) of 76 % and a negative predictive value (NPV) of 69 %. The specificity of MDCT was 89 % and sensitivity was 46 %. Comparison between radiologic suspected cartilage invasion and histologic results showed a significant correlation (p < 0.02). We found no significant impact of cartilage invasion concerning survival rates (5-year overall survival p = 0.683; 5-year disease-free survival p = 0.711). Preoperative CT scan is an important instrument in detecting neoplastic cartilage invasion.
Collapse
Affiliation(s)
- Mario Koopmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany.
| | - Daniel Weiss
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany
| | - Matthias Steiger
- Department of Clinical Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Sandra Elges
- Gerhard-Domagk-Institute of Pathology, University Hospital Münster, Domagkstraße 17, 48149, Münster, Germany
| | - Claudia Rudack
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany
| | - Markus Stenner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany
| |
Collapse
|
3
|
Adolphs APJ, Boersma NA, Diemel BDM, Eding JEC, Flokstra FE, Wegner I, Grolman W, Braunius W. A systematic review of computed tomography detection of cartilage invasion in laryngeal carcinoma. Laryngoscope 2015; 125:1650-5. [DOI: 10.1002/lary.25145] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Anda P. J. Adolphs
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
| | - Nienke A. Boersma
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
| | - Babette D. M. Diemel
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
| | - Joep E. C. Eding
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
| | - Francien E. Flokstra
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
| | - Inge Wegner
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht the Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht the Netherlands
| | - Weibel Braunius
- Department of Otorhinolaryngology-Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
| |
Collapse
|
4
|
|
5
|
Diffusion-weighted MRI in diagnosing thyroid cartilage invasion in laryngeal carcinoma. Eur Arch Otorhinolaryngol 2013; 271:2511-6. [DOI: 10.1007/s00405-013-2782-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/12/2013] [Indexed: 11/30/2022]
|
6
|
CT-scan prediction of thyroid cartilage invasion for early laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2012; 270:287-91. [DOI: 10.1007/s00405-012-2005-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 03/15/2012] [Indexed: 10/28/2022]
|
7
|
Accuracy of magnetic resonance imaging in diagnosing thyroid cartilage and thyroid gland invasion by squamous cell carcinoma in laryngectomy patients. The Journal of Laryngology & Otology 2012; 126:302-6. [PMID: 22234175 DOI: 10.1017/s0022215111003331] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES We examined the accuracy of magnetic resonance imaging in assessing thyroid cartilage and thyroid gland invasion in patients undergoing total laryngectomy for squamous cell carcinoma, by comparing histopathology results with imaging findings. STUDY DESIGN A retrospective study reviewed histology and magnetic resonance scan results for all total laryngectomies performed between 1998-2008 at University Hospital Aintree, Liverpool. METHODS Pre-operative magnetic resonance images were reviewed independently by two consultant head and neck radiologists masked to the histology; their opinions were then compared with histology findings. RESULTS Eighty-one magnetic resonance scans were reviewed. There were 22 laryngectomy patients with histologically verified thyroid cartilage invasion and one patient with thyroid gland invasion. There were 31 patients with apparent radiological thyroid cartilage invasion pre-operatively (with 17 false positives), giving sensitivity, specificity, and positive and negative predictive values of 64, 71, 45 and 84 per cent, respectively. On assessing thyroid gland invasion, there were nine false positive scans and no false negative scans, giving sensitivity, specificity, and positive and negative predictive values of 100, 89, 10 and 100 per cent, respectively. CONCLUSION Magnetic resonance scanning over-predicts thyroid cartilage and gland invasion in patients undergoing total laryngectomy. Magnetic resonance scans have limited effectiveness in predicting thyroid cartilage invasion by squamous cell carcinoma in laryngectomy patients.
Collapse
|
8
|
Aragão Jr. AGM, Souza RPD, Rapoport A. Contribuição da tomografia computadorizada no estadiamento do carcinoma de células escamosas da supraglote. Radiol Bras 2007. [DOI: 10.1590/s0100-39842007000400008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Este trabalho tem como objetivos avaliar a influência da tomografia computadorizada no estadiamento local da classificação TNM dos tumores da supraglote e avaliar a concordância interobservadores na detecção da extensão tumoral. MATERIAIS E MÉTODOS: Foram avaliados, retrospectivamente, 39 pacientes com carcinoma de células escamosas da supraglote atendidos no Hospital Heliópolis entre 1988 e 1998. Os exames de tomografia computadorizada foram analisados por dois radiologistas individualmente. Para a avaliação da concordância interobservadores utilizou-se o índice kappa. RESULTADOS: A tomografia computadorizada foi determinante no estadiamento mais avançado em 38,5% dos casos, decorrente de extensão tumoral profunda não-identificada no exame clínico. CONCLUSÃO: A concordância interobservadores foi considerada ótima para as pregas vocais e subglote; boa para a supraglote, espaços paraglótico e pré-epiglótico, cartilagens cricóide e tireóide e para extensão tumoral extralaríngea; e regular para a base da língua.
Collapse
|
9
|
Volpato R, Souza RPD, Rapoport A, Carvalho Neto PBD, Beserra Júnior IM. O papel da tomografia computadorizada no estadiamento e tratamento cirúrgico do carcinoma epidermóide do seio piriforme. Rev Col Bras Cir 2007. [DOI: 10.1590/s0100-69912007000200003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Determinar a real extensão das neoplasias do seio piriforme através da tomografia computadorizada após estadiamento clínico/endoscópico (seio piriforme, prega ariepiglótica, espaço paraglótico, glote, subglote, orofaringe, cartilagem tireóide, cartilagem cricóide, cartilagem aritenóide, esôfago cervical, extensão para tecidos moles extralaríngeos e musculatura pré-vertebral) e sua repercussão no planejamento cirúrgico. MÉTODO: O estudo incluiu pacientes portadores de carcinoma epidermóide de seio piriforme, atendidos no Departamento de Cabeça e Pescoço e Otorrinolaringologia do Hospital Heliópolis, Hosphel, São Paulo de 1988 e 2003. Foram avaliados os prontuários de 31 pacientes, sendo 29 (93,5%) do sexo masculino e dois (6,5%) do sexo feminino. A análise das tomografias foi realizada por três radiologistas individualmente e para o estudo da concordância interobservadores, foi utilizado o índice Kappa. RESULTADOS: A TC apresentou: forte concordância na avaliação de seio piriforme, prega ariepiglótica, espaço paraglótico e subglote; boa concordância para a orofaringe, glote, cartilagem cricóide, esôfago cervical e tecidos moles extralaríngeos; moderada para as cartilagens tireóide e aritenóide; fraca no estudo da musculatura pré-vertebral. CONCLUSÃO: A avaliação interobservadores das imagens do CEC do seio priforme determina o re-estadiamento TNM e conseqüente mudanças do paradigma cirúrgico.
Collapse
|
10
|
de Souza RP, de Barros N, Paes Junior AJDO, Tornin ODS, Rapoport A, Cerri GG. Value of computed tomography for evaluating the subglottis in laryngeal and hypopharyngeal squamous cell carcinoma. SAO PAULO MED J 2007; 125:73-6. [PMID: 17625703 PMCID: PMC11014700 DOI: 10.1590/s1516-31802007000200002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2003] [Revised: 12/10/2003] [Accepted: 02/28/2007] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Subglottic involvement in squamous cell carcinoma is a determining factor for contraindicating conservative partial surgery. The subglottis is easily identified by axial computed tomography sections. The present study aimed to evaluate the occurrence of false-negative and false-positive results, and the overall accuracy of staging by computed tomography, in order to detect the involvement of the subglottic laryngeal compartment, in cases of laryngeal and hypopharyngeal squamous cell carcinoma. DESIGN AND SETTING Retrospective, non-randomized study of patients treated at Hospital Heliópolis, São Paulo, Brazil. METHODS Computed tomography scans were performed on third-generation equipment with 5-mm slice thickness. Afterwards, all patients underwent surgical and anatomopathological examinations as the gold standard procedures. RESULTS Among 60 patients, 14 were diagnosed with subglottic extension by surgical and histopathological examination. There were three false-negative and no false-positive results from computed tomography scans. The sensitivity and negative predictive value were 100.0%. Accuracy was 95.0%, specificity was 93.5% and positive predictive value was 82.4%. CONCLUSIONS Computed tomography could serve as a powerful auxiliary method for staging laryngeal and hypopharyngeal cancer. However, precautions should be taken in analyzing computed tomography scan data, because vegetating lesions may also be projected into the subglottic compartment, without real involvement of the subglottis, which may cause a false-positive result.
Collapse
|
11
|
Daisne JF, Duprez T, Weynand B, Lonneux M, Hamoir M, Reychler H, Grégoire V. Tumor Volume in Pharyngolaryngeal Squamous Cell Carcinoma: Comparison at CT, MR Imaging, and FDG PET and Validation with Surgical Specimen. Radiology 2004; 233:93-100. [PMID: 15317953 DOI: 10.1148/radiol.2331030660] [Citation(s) in RCA: 473] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare computed tomography (CT), magnetic resonance (MR) imaging, and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) for delineation of gross tumor volume (GTV) in pharyngolaryngeal squamous cell carcinoma and to validate results with the macroscopic surgical specimen when available. MATERIALS AND METHODS Twenty-nine patients with stages II-IV squamous cell carcinoma treated with radiation therapy or chemotherapy and radiation therapy (n = 20) or with total laryngectomy (n = 9) were enrolled. Ten patients had oropharyngeal, 13 had laryngeal, and six had hypopharyngeal tumors. CT, MR imaging, and PET were performed with patients immobilized in a customized thermoplastic mask, and images were coregistered. GTVs obtained with the three modalities were compared quantitatively and qualitatively. If patients underwent total laryngectomy, images were validated with the surgical specimen after three-dimensional coregistration. The effect of each modality was estimated with linear mixed-effects models. Adjustments for multiple comparisons were made with the Bonferonni or Sidak method. RESULTS For oropharyngeal tumors and for laryngeal or hypopharyngeal tumors, no significant difference (P >.99) was observed between average GTVs delineated at CT (32.0 and 21.4 cm(3), respectively) or MR imaging (27.9 and 21.4 cm(3), respectively), whereas average GTVs at PET were smaller (20.3 [P </=.10] and 16.4 cm(3) [P </=.01], respectively). GTVs from surgical specimens were significantly smaller (12.6 cm(3), P </=.06). In nine patients for whom a surgical specimen was available, no modality adequately depicted superficial tumor extension; this was due to limitations in spatial resolution. In addition, false-positive results were seen for cartilage, extralaryngeal, and preepiglottic extensions. CONCLUSION Compared with GTVs at CT and MR imaging, GTVs at FDG PET were smaller. In nine patients for whom a surgical specimen was available, PET was found to be the most accurate modality. However, no modality managed to depict superficial tumor extension.
Collapse
Affiliation(s)
- Jean-François Daisne
- Head and Neck Oncology Program, St-Luc University Hospital, Université Catholique de Louvain, 10 Ave Hippocrate, 1200 Brussels, Belgium
| | | | | | | | | | | | | |
Collapse
|
12
|
Paiva RGS, Souza RPD, Rapoport A, Soares AH. Avaliação por tomografia computadorizada do envolvimento loco-regional do carcinoma espinocelular de corda vocal. Radiol Bras 2001. [DOI: 10.1590/s0100-39842001000400004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
No período de 1992 a 1998, foram avaliados, retrospectivamente, exames de tomografia computadorizada e prontuários de 22 pacientes com carcinoma espinocelular de corda vocal. Avaliou-se a concordância entre observadores para todos os casos e a acurácia e concordância entre os métodos para os casos operados, utilizando-se o índice kappa. A concordância foi excelente para o comprometimento tumoral das cartilagens tireóide, cricóide, extensão extralaríngea e estadiamento linfonodal; ótima para o envolvimento tumoral das cordas vocais, comissura posterior e espaço paraglótico; boa para o envolvimento tumoral da supraglote, subglote e estadiamento tumoral; regular para o envolvimento tumoral da comissura anterior e cartilagem aritenóide. A utilização simultânea da avaliação clínica e tomográfica para o estadiamento T obteve acurácia e concordância com achados patológicos de 89,47% e 84,9%, respectivamente, sendo superior à análise clínica isolada ou tomográfica. A acurácia e concordância patológica da tomografia computadorizada para o estadiamento N foi de 100%, sendo superior à avaliação clínica.
Collapse
|