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Parsaei M, Sanjari Moghaddam H, Mazaheri P. The clinical utility of diffusion-weighted imaging in diagnosing and predicting treatment response of laryngeal and hypopharyngeal carcinoma: A systematic review and meta-analysis. Eur J Radiol 2024; 177:111550. [PMID: 38878501 DOI: 10.1016/j.ejrad.2024.111550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 04/24/2024] [Accepted: 06/02/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE Laryngeal and Hypopharyngeal Carcinomas (LC/HPC) constitute about 24 % of head and neck cancers, causing more than 90,000 annual deaths worldwide. Diffusion-Weighted Imaging (DWI), is currently widely studied in oncologic imaging and can aid in distinguishing cellular tumors from other tissues. Our objective was to review the effectiveness of DWI in three areas: diagnosing, predicting prognosis, and predicting treatment response in patients with LC/HPC. METHODS A systematic search was conducted in PubMed, Web of Science, and Embase. A meta-analysis by calculating Standardized Mean Difference (SMD) and 95 % Confidence Interval (CI) was conducted on diagnostic studies. RESULTS A total of 16 studies were included. All diagnostic studies (n = 9) were able to differentiate between the LC/HPC and other benign laryngeal/hypopharyngeal lesions. These studies found that LC/HPC had lower Apparent Diffusion Coefficient (ADC) values than non-cancerous lesions. Our meta-analysis of 7 diagnostic studies, that provided ADC values of malignant and non-malignant tissues, demonstrated significantly lower ADC values in LC/HPC compared to non-malignant lesions (SMD = -1.71, 95 %CI: [-2.00, -1.42], ADC cut-off = 1.2 × 103 mm2/s). Furthermore, among the studies predicting prognosis, 67 % (4/6) accurately predicted outcomes based on pretreatment ADC values. Similarly, among studies predicting treatment response, 50 % (2/4) successfully predicted outcomes based on pretreatment ADC values. Overall, the studies that looked at prognosis or treatment response in LC/HPC found a positive correlation between pretreatment ADC values in larynx/hypopharynx and favorable outcomes. CONCLUSION DWI aids significantly in the LC/HPC diagnosis. However, further research is needed to establish DWI's reliability in predicting prognosis and treatment response in patients with LC/HPC.
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Affiliation(s)
| | - Hossein Sanjari Moghaddam
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Mazaheri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
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2
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Crosetti E, Fantini M, Bertotto I, Bertolin A, Arrigoni G, Lorenzi A, Succo G. Current Status of Partial Laryngeal Surgery for Advanced Laryngeal Cancer: When and Why? Curr Oncol Rep 2024; 26:614-624. [PMID: 38647994 PMCID: PMC11168980 DOI: 10.1007/s11912-024-01516-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW This paper aims to evaluate the evolution and current status of partial laryngeal surgery in the treatment of advanced laryngeal cancer (LC). Specifically, recent progress in the selection of both patients and tumors, together with surgical and rehabilitation innovations, have contributed to balancing oncological control with the maintenance of quality of life in naïve and radiorecurrent patients. The main aspect is represented by the recognized role of open partial horizontal laryngectomies (OPHLs) in this new era of laryngeal cancer treatment. RECENT FINDINGS Recent advancements highlight OPHLs' efficacy for conservative management of intermediate to advanced stages of LC. Innovations such as supratracheal partial laryngectomy have expanded surgical options, offering a modular approach to complex cases. Improved understanding of tumor biology, enhanced imaging techniques, and more precise preoperative planning have led to better patient outcomes, emphasizing the importance of a conservative function-preserving surgical treatment. These advancements reflect a broader trend towards individualized treatment plans that prioritize both survival and quality of life. OPHLs play an important role in current management of intermediate/advanced LC, effectively balancing oncological control with the preservation of laryngeal functions. Critical factors include meticulous patient and tumor selection, the impact of surgical and technological refinements on functional outcomes, and the necessity of a multidisciplinary approach in treatment planning. Current evidence justifies the use of these interventions in many intermediate T-stage laryngeal tumors, even at risk of upstaging on pathological examination. The oncological results, the preservation of laryngeal function and the laryngectomy-free survival achieved with OPHLs appear to be highly competitive with those of non surgical organ-preservation protocols, aiming to introduce a new standard in the LC treatment.
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Affiliation(s)
- Erika Crosetti
- ENT Clinic - Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Marco Fantini
- ENT Clinic - Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Ilaria Bertotto
- Radiology Department, Candiolo Cancer Institute - IRCCS, Candiolo, TO, Italy
| | - Andy Bertolin
- ENT Department, Vittorio Veneto Hospital, AULSS 2 Marca Trevigiana, Treviso, Italy
| | - Giulia Arrigoni
- ENT Clinic - Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Andrea Lorenzi
- ENT Clinic - Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Giovanni Succo
- ENT Clinic - Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy.
- Department of Oncology, University of Turin, Turin, Italy.
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Pucėtaitė M, Farina D, Ryškienė S, Mitraitė D, Tarasevičius R, Lukoševičius S, Padervinskis E, Vaitkus S. The Diagnostic Value of CEUS in Assessing Non-Ossified Thyroid Cartilage Invasion in Patients with Laryngeal Squamous Cell Carcinoma. J Clin Med 2024; 13:891. [PMID: 38337585 PMCID: PMC10856113 DOI: 10.3390/jcm13030891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Accurate assessment of thyroid cartilage invasion in squamous cell carcinoma (SCC) of the larynx remains a challenge in clinical practice. The aim of this study was to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS), contrast-enhanced computed tomography (CECT), and magnetic resonance imaging (MRI) in the detection of non-ossified thyroid cartilage invasion in patients with SCC. Methods: CEUS, CECT, and MRI scans of 27 male patients with histologically proven SCC were evaluated and compared. A total of 31 cases were assessed via CEUS and CECT. The MR images of five patients and six cases were excluded (one patient had two suspected sites), leaving twenty-five cases for analysis via MRI. Results: CEUS showed the highest accuracy and specificity compared with CECT and MRI (87.1% vs. 64.5% and 76.0% as well as 84.0% vs. 64.0% and 72.7%, respectively). The sensitivity and negative predictive value of CEUS and MRI were the same (100%). CEUS yielded four false-positive findings. However, there were no statistically significant differences among the imaging modalities (p > 0.05). Conclusions: CEUS showed better diagnostic performance than CECT and MRI. Therefore, CEUS has the potential to accurately assess non-ossified thyroid cartilage invasion and guide appropriate treatment decisions, hopefully leading to improved patient outcomes.
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Affiliation(s)
- Milda Pucėtaitė
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, 44307 Kaunas, Lithuania; (S.R.); (D.M.)
| | - Davide Farina
- Department of Radiological Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy;
| | - Silvija Ryškienė
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, 44307 Kaunas, Lithuania; (S.R.); (D.M.)
| | - Dalia Mitraitė
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, 44307 Kaunas, Lithuania; (S.R.); (D.M.)
| | - Rytis Tarasevičius
- Department of Radiology, Lithuanian University of Health Sciences Kaunas Clinics, Eivenių 2, 50009 Kaunas, Lithuania
| | - Saulius Lukoševičius
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, 44307 Kaunas, Lithuania; (S.R.); (D.M.)
| | - Evaldas Padervinskis
- Department of Otorhinolaryngology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, 44307 Kaunas, Lithuania; (E.P.); (S.V.)
| | - Saulius Vaitkus
- Department of Otorhinolaryngology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, 44307 Kaunas, Lithuania; (E.P.); (S.V.)
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Crosetti E, Succo G, Sapino S, Bertotto I, Cirillo S, Petracchini M, Fondello G, Arrigoni G, Tascone M, Piazza C, Farina D, Ravanelli M. Twenty questions from the surgeon to the radiologist to better plan an open partial horizontal laryngectomy. Front Oncol 2024; 13:1305889. [PMID: 38328437 PMCID: PMC10847842 DOI: 10.3389/fonc.2023.1305889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/18/2023] [Indexed: 02/09/2024] Open
Abstract
Open partial horizontal laryngectomies (OPHLs) represent a valuable therapeutic option for tumors of the intermediate T-category and, in selected cases, for locally advanced tumors with low-volume extra-laryngeal extension. The eligibility of patients treated with this type of surgery has increased with the introduction of the modular approach to OPHL planning. This strategy follows the introduction of the classification proposed by the European Laryngological Society, based on the extent of horizontal resection. Optimization of the selection is the result of a meticulous work-up process involving close cooperation between experienced surgeons and radiologists, followed by final quality control by pathologists. Computed tomography and magnetic resonance imaging are study methods whose pearls and pitfalls are well known, especially when performed at a high level of expertise. In this paper, based on the experience of two high-volume centers, a checklist of 20 questions addressed by the surgeon to the radiologist before planning an OPHL was proposed. Considerations regarding case selection are reported for each of the questioned parameters. A very simple question-and-answer process is easy to understand and mainly addressed by less experienced colleagues who wish to increase their knowledge and skills in performing this type of surgery.
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Affiliation(s)
- Erika Crosetti
- Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Giovanni Succo
- Oncology Department, University of Turin, Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Silvia Sapino
- Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Ilaria Bertotto
- Radiology Service, Candiolo Cancer Institute, Candiolo, Italy
| | - Stefano Cirillo
- Radiology Service, Mauriziano Umberto I Hospital, Turin, Italy
| | | | | | - Giulia Arrigoni
- Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Martina Tascone
- Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Cesare Piazza
- Department of Otorhinolaryngology—Head and Neck Surgery, ASST Spedali Civili di Brescia, University of Brescia, School of Medicine, Brescia, Italy
| | - Davide Farina
- Department of Radiology, University of Brescia, Brescia, Italy
| | - Marco Ravanelli
- Department of Radiology, University of Brescia, Brescia, Italy
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Shiri I, Amini M, Yousefirizi F, Vafaei Sadr A, Hajianfar G, Salimi Y, Mansouri Z, Jenabi E, Maghsudi M, Mainta I, Becker M, Rahmim A, Zaidi H. Information fusion for fully automated segmentation of head and neck tumors from PET and CT images. Med Phys 2024; 51:319-333. [PMID: 37475591 DOI: 10.1002/mp.16615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/16/2023] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND PET/CT images combining anatomic and metabolic data provide complementary information that can improve clinical task performance. PET image segmentation algorithms exploiting the multi-modal information available are still lacking. PURPOSE Our study aimed to assess the performance of PET and CT image fusion for gross tumor volume (GTV) segmentations of head and neck cancers (HNCs) utilizing conventional, deep learning (DL), and output-level voting-based fusions. METHODS The current study is based on a total of 328 histologically confirmed HNCs from six different centers. The images were automatically cropped to a 200 × 200 head and neck region box, and CT and PET images were normalized for further processing. Eighteen conventional image-level fusions were implemented. In addition, a modified U2-Net architecture as DL fusion model baseline was used. Three different input, layer, and decision-level information fusions were used. Simultaneous truth and performance level estimation (STAPLE) and majority voting to merge different segmentation outputs (from PET and image-level and network-level fusions), that is, output-level information fusion (voting-based fusions) were employed. Different networks were trained in a 2D manner with a batch size of 64. Twenty percent of the dataset with stratification concerning the centers (20% in each center) were used for final result reporting. Different standard segmentation metrics and conventional PET metrics, such as SUV, were calculated. RESULTS In single modalities, PET had a reasonable performance with a Dice score of 0.77 ± 0.09, while CT did not perform acceptably and reached a Dice score of only 0.38 ± 0.22. Conventional fusion algorithms obtained a Dice score range of [0.76-0.81] with guided-filter-based context enhancement (GFCE) at the low-end, and anisotropic diffusion and Karhunen-Loeve transform fusion (ADF), multi-resolution singular value decomposition (MSVD), and multi-level image decomposition based on latent low-rank representation (MDLatLRR) at the high-end. All DL fusion models achieved Dice scores of 0.80. Output-level voting-based models outperformed all other models, achieving superior results with a Dice score of 0.84 for Majority_ImgFus, Majority_All, and Majority_Fast. A mean error of almost zero was achieved for all fusions using SUVpeak , SUVmean and SUVmedian . CONCLUSION PET/CT information fusion adds significant value to segmentation tasks, considerably outperforming PET-only and CT-only methods. In addition, both conventional image-level and DL fusions achieve competitive results. Meanwhile, output-level voting-based fusion using majority voting of several algorithms results in statistically significant improvements in the segmentation of HNC.
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Affiliation(s)
- Isaac Shiri
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Mehdi Amini
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Fereshteh Yousefirizi
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Alireza Vafaei Sadr
- Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, USA
| | - Ghasem Hajianfar
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Yazdan Salimi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Zahra Mansouri
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Elnaz Jenabi
- Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Maghsudi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ismini Mainta
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Minerva Becker
- Service of Radiology, Geneva University Hospital, Geneva, Switzerland
| | - Arman Rahmim
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
- Department of Radiology and Physics, University of British Columbia, Vancouver, Canada
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
- Geneva University Neurocenter, Geneva University, Geneva, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark
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Becker M, de Vito C, Dulguerov N, Zaidi H. PET/MR Imaging in Head and Neck Cancer. Magn Reson Imaging Clin N Am 2023; 31:539-564. [PMID: 37741640 DOI: 10.1016/j.mric.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) can either be examined with hybrid PET/MR imaging systems or sequentially, using PET/CT and MR imaging. Regardless of the acquisition technique, the superiority of MR imaging compared to CT lies in its potential to interrogate tumor and surrounding tissues with different sequences, including perfusion and diffusion. For this reason, PET/MR imaging is preferable for the detection and assessment of locoregional residual/recurrent HNSCC after therapy. In addition, MR imaging interpretation is facilitated when combined with PET. Nevertheless, distant metastases and distant second primary tumors are detected equally well with PET/MR imaging and PET/CT.
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Affiliation(s)
- Minerva Becker
- Diagnostic Department, Division of Radiology, Unit of Head and Neck and Maxillofacial Radiology, Geneva University Hospitals, University of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland.
| | - Claudio de Vito
- Diagnostic Department, Division of Clinical Pathology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland
| | - Nicolas Dulguerov
- Department of Clinical Neurosciences, Clinic of Otorhinolaryngology, Head and Neck Surgery, Unit of Cervicofacial Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland
| | - Habib Zaidi
- Diagnostic Department, Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, University of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland; Geneva University Neurocenter, University of Geneva, Geneva, Switzerland; Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark
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Mohamad I, Hejleh TA, Qandeel M, Al-Hussaini M, Koro S, Taqash A, Almousa A, Abuhijla F, Abuhijlih R, Ajlouni F, Al-Ibraheem A, Laban DA, Hussein T, Mayta E, Al-Gargaz W, Hosni A. Concordance between head and neck MRI and histopathology in detecting laryngeal subsite invasion among patients with laryngeal cancer. Cancer Imaging 2023; 23:99. [PMID: 37858162 PMCID: PMC10585883 DOI: 10.1186/s40644-023-00618-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/07/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Accuracy of head and neck MRI (HN-MRI) in predicting tumor invasion of laryngeal site/subsites in patients with laryngeal cancer prior to laryngectomy is poorly evaluated in the literature. Therefore, we aim to evaluate the diagnostic value of HN-MRI in accurate pre-operative estimation of tumor invasion to laryngeal subsites in patients with laryngeal cancer. METHODS Patients with laryngeal cancer who underwent HN-MRI for cancer staging and underwent total laryngectomy between 2008 and 2021 were included. Sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of HN-MRI in predicting tumor invasion of laryngeal subsites were calculated based on concordance between the HN-MRI and histopathological results. RESULTS One hundred and thirty-seven patients underwent total laryngectomy [primary: 82/137(60%), salvage 55/137(40%)]. The utilization of HN-MRI resulted in the downstaging of 16/137 (11.6%) patients and the upstaging of 8/137 (5.8%) patients. For the whole cohort, there was a significant discordance between HN-MRI and histopathology for T-category; out of 116 cT4a disease, 102(87.9%) were confirmed to have pT4a disease, and out of 17 cT3 disease, 9(52.9%) were confirmed to have pT3 disease, p < 0.001. The MRI overall diagnostic accuracy of predicting tumor invasion was 91%, 92%, 82%, 87%, 72%, 76%, 65% and 68% for base of tongue, arytenoid, vocal cord, posterior commissure, pre-epiglottic space, cricoid cartilage, inner thyroid cortex, and subglottis, respectively. CONCLUSIONS In patients with laryngeal cancer undergoing total laryngectomy, HN-MRI demonstrates promising accuracy in predicting tumor invasion of specific laryngeal subsites (e.g., base of tongue). Our findings showed the potential of HN-MRI as a valuable tool for pre-operative planning and treatment decision-making in this patient population.
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Affiliation(s)
- Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan.
| | - Taher Abu Hejleh
- Department of Medical Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Monther Qandeel
- Department of Diagnostic Radiology, King Hussein Cancer Center, Amman, Jordan
| | - Maysa Al-Hussaini
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Sami Koro
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA
| | - Ayat Taqash
- Department of Biostatistics, King Hussein Cancer Center, Amman, Jordan
| | - Abdelatif Almousa
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Fawzi Abuhijla
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Ramiz Abuhijlih
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Fatenah Ajlouni
- Department of Diagnostic Radiology, King Hussein Cancer Center, Amman, Jordan
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Dima Abu Laban
- Department of Diagnostic Radiology, King Hussein Cancer Center, Amman, Jordan
| | - Tariq Hussein
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Ebrahim Mayta
- Department of Surgical Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Wisam Al-Gargaz
- Department of Surgical Oncology, King Hussein Cancer Center, Amman, Jordan
- Department of Special Surgery, Jordan , University of Science and Technology, Irbid, Jordan
| | - Ali Hosni
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
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Lin YC, Lin G, Pandey S, Yeh CH, Wang JJ, Lin CY, Ho TY, Ko SF, Ng SH. Fully automated segmentation and radiomics feature extraction of hypopharyngeal cancer on MRI using deep learning. Eur Radiol 2023; 33:6548-6556. [PMID: 37338554 PMCID: PMC10415433 DOI: 10.1007/s00330-023-09827-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 03/29/2023] [Accepted: 04/14/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES To use convolutional neural network for fully automated segmentation and radiomics features extraction of hypopharyngeal cancer (HPC) tumor in MRI. METHODS MR images were collected from 222 HPC patients, among them 178 patients were used for training, and another 44 patients were recruited for testing. U-Net and DeepLab V3 + architectures were used for training the models. The model performance was evaluated using the dice similarity coefficient (DSC), Jaccard index, and average surface distance. The reliability of radiomics parameters of the tumor extracted by the models was assessed using intraclass correlation coefficient (ICC). RESULTS The predicted tumor volumes by DeepLab V3 + model and U-Net model were highly correlated with those delineated manually (p < 0.001). The DSC of DeepLab V3 + model was significantly higher than that of U-Net model (0.77 vs 0.75, p < 0.05), particularly in those small tumor volumes of < 10 cm3 (0.74 vs 0.70, p < 0.001). For radiomics extraction of the first-order features, both models exhibited high agreement (ICC: 0.71-0.91) with manual delineation. The radiomics extracted by DeepLab V3 + model had significantly higher ICCs than those extracted by U-Net model for 7 of 19 first-order features and for 8 of 17 shape-based features (p < 0.05). CONCLUSION Both DeepLab V3 + and U-Net models produced reasonable results in automated segmentation and radiomic features extraction of HPC on MR images, whereas DeepLab V3 + had a better performance than U-Net. CLINICAL RELEVANCE STATEMENT The deep learning model, DeepLab V3 + , exhibited promising performance in automated tumor segmentation and radiomics extraction for hypopharyngeal cancer on MRI. This approach holds great potential for enhancing the radiotherapy workflow and facilitating prediction of treatment outcomes. KEY POINTS • DeepLab V3 + and U-Net models produced reasonable results in automated segmentation and radiomic features extraction of HPC on MR images. • DeepLab V3 + model was more accurate than U-Net in automated segmentation, especially on small tumors. • DeepLab V3 + exhibited higher agreement for about half of the first-order and shape-based radiomics features than U-Net.
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Affiliation(s)
- Yu-Chun Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St., Guishan, Taoyuan, 33382, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St., Guishan, Taoyuan, 33382, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Sumit Pandey
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St., Guishan, Taoyuan, 33382, Taiwan
| | - Chih-Hua Yeh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St., Guishan, Taoyuan, 33382, Taiwan
| | - Jiun-Jie Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Tsung-Ying Ho
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Sheung-Fat Ko
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St., Guishan, Taoyuan, 33382, Taiwan.
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Itamura K, Hsue VB, Barbu AM, Chen MM. Diagnostic Assessment (Imaging) and Staging of Laryngeal Cancer. Otolaryngol Clin North Am 2023; 56:215-231. [PMID: 37030936 DOI: 10.1016/j.otc.2022.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2023]
Abstract
Diagnosis of larynx cancer relies on a detailed history and physical and objective assessment with endoscopy and imaging. Endoscopy is needed to assess for vocal fold function that directly affects staging. Computed tomography and MRI can be used to assess for tumor extent in relation to intra- and extra-laryngeal structures, especially paraglottic and pre-epiglottic space involvement as well as cartilage invasion. Accurate staging is critical for subsequent treatment decision-making regarding larynx preservation.
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Affiliation(s)
- Kyohei Itamura
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, 8635 West Third Street #590W, Los Angeles, CA 90048, USA
| | - Victor B Hsue
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, 8635 West Third Street #590W, Los Angeles, CA 90048, USA
| | - Anca M Barbu
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, 8635 West Third Street #590W, Los Angeles, CA 90048, USA
| | - Michelle M Chen
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, 8635 West Third Street #590W, Los Angeles, CA 90048, USA; Department of Otolaryngology-Head and Neck Surgery, Stanford University, 900 Blake Wilbur Drive Rm W3045, Stanford, CA 94305, USA.
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10
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Zhou L, Qin S, Zhang Q, Xu J. Clinical characteristics and risk factors of central lymph node and thyroid metastasis in patients with hypopharyngeal carcinoma. Am J Otolaryngol 2023; 44:103742. [PMID: 36610248 DOI: 10.1016/j.amjoto.2022.103742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/18/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Our study sought to analyze the clinical characteristics and risk factors of central lymph node and thyroid metastasis in patients with hypopharyngeal carcinoma. METHODS The current study included a total of 152 patients who suffered from hypopharyngeal cancer in our hospital from January 2019 to December 2020. Univariate/multivariate Logistic regression analyses were applied to analyze the risk factors of both central lymph nodes and thyroid metastasis in patients with hypopharyngeal cancer. RESULTS Significant differences were found in tobacco use, drinking history, PS score, site of tumor, pT and pN stage, pathological stage, differentiation degree, postoperative calcium ion level and postoperative FT3 level between the thyroid metastasis group and the non-thyroid metastasis group, and between the central lymph node metastasis group and the non-central lymph node metastasis group (P < 0.05). The multivariate logistic regression analysis showed that the risk factors of thyroid metastasis in patients with hypopharyngeal cancer were pathological stage and differentiation degree. CONCLUSIONS Patients with hypopharyngeal cancer complicated by thyroid metastasis or central lymph node metastasis may be associated with tobacco use, drinking history, PS score, site of tumor, pT and pN stage, pathological stage, differentiation degree, postoperative calcium ion level, and postoperative FT3 level. Moreover, the risk factors responsible for central lymph node and thyroid metastasis in hypopharyngeal cancer patients were thought related to pathological stage and differentiation degree.
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Affiliation(s)
- Liangfa Zhou
- Department of Oncology, Wuhan No.1 Hospital (Wuhan Hospital of Traditional Chinese and Western Medicine), Wuhan, Hubei Province, China
| | - Shuanglai Qin
- Department of Oncology, Wuhan No.1 Hospital (Wuhan Hospital of Traditional Chinese and Western Medicine), Wuhan, Hubei Province, China
| | - Qiu Zhang
- Department of Otorhinolaryngology, Wuhan No.1 Hospital (Wuhan Hospital of Traditional Chinese and Western Medicine), Wuhan, Hubei Province, China
| | - Jian Xu
- Department of Abdominal and Pelvic Medical Oncology, Huangshi Central Hospital Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi, Hubei Province, China.
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11
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Kokje V, De Vito C, Varela FC, Monnier Y, Dulguerov N, Becker M, Mermod M. Rosai-Dorfman disease presenting as stridor and hoarseness in a young female patient. Radiol Case Rep 2023; 18:591-595. [PMCID: PMC9703459 DOI: 10.1016/j.radcr.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Vivianne Kokje
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Claudio De Vito
- Division of Clinical Pathology, Diagnostic Department, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Flavia Costa Varela
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
- Division of Clinical Pathology, Diagnostic Department, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
- Service of Radiology, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Yan Monnier
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Nicolas Dulguerov
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Minerva Becker
- Service of Radiology, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
| | - Maxime Mermod
- Department of Otorhinolaryngology—Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland
- Corresponding author.
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12
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Schleder S, May M, Scholz C, Dinkel J, Strotzer Q, Einspieler I, Dollinger M, Schreyer AG, Grassinger J, Schicho A. Diagnostic Value of Diffusion-Weighted Imaging with Background Body Signal Suppression (DWIBS) for the Pre-Therapeutic Loco-Regional Staging of Cervical Cancer: A Feasibility and Interobserver Reliability Study. Curr Oncol 2023; 30:1164-1173. [PMID: 36661738 PMCID: PMC9857406 DOI: 10.3390/curroncol30010089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/30/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
(1) Background: cervical cancer is one of the leading causes of cancer-related deaths and the fourth most common cancer among women worldwide. Magnetic resonance imaging (MRI) is the modality of choice for loco-regional staging of cervical cancer in the primary diagnostic workup beginning with at least stage IB. (2) Methods: we retrospectively analyzed 16 patients with histopathological proven cervical cancer (FIGO IB1−IVA) for the diagnostic accuracy of standard MRI and standard MRI with diffusion-weighted imaging with background body signal suppression (DWIBS) for the correct pre-therapeutic assessment of the definite FIGO category. (3) Results: In 7 out of 32 readings (22%), DWIBS improved diagnostic accuracy. With DWIBS, four (13%) additional readings were assigned the correct major (I−IV) FIGO stages pre-therapeutically. Interobserver reliability of DWIBS was weakest for parametrial infiltration (k = 0.43; CI-95% 0.00−1.00) and perfect for tumor size <2 cm, infiltration of the vaginal lower third, infiltration of adjacent organs and loco-regional nodal metastases (k = 1.000; CI-95% 1.00−1.00). (4) Conclusions: the pre-therapeutic staging of cervical cancer has a high diagnostic accuracy and interobserver reliability when using standard MRI but can be further optimized with the addition of DWIBS sequences when reporting is performed by an experienced radiologist.
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Affiliation(s)
- Stephan Schleder
- Department of Diagnostic and Interventional Radiology, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany
| | - Matthias May
- Department of Urology, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany
| | - Carsten Scholz
- Department of Gynecology and Obstetrics, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany
| | - Johannes Dinkel
- Department of Radiology, University Medical Center Regensburg, 93055 Regensburg, Germany
| | - Quirin Strotzer
- Department of Radiology, University Medical Center Regensburg, 93055 Regensburg, Germany
| | - Ingo Einspieler
- Department of Radiology, University Medical Center Regensburg, 93055 Regensburg, Germany
| | - Marco Dollinger
- Department of Radiology, University Medical Center Regensburg, 93055 Regensburg, Germany
| | - Andreas G. Schreyer
- Department of Diagnostic and Interventional Radiology, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg, Germany
| | - Jochen Grassinger
- Department of Hematology and Oncology, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany
| | - Andreas Schicho
- Department of Radiology, University Medical Center Regensburg, 93055 Regensburg, Germany
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13
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Additional Diffusion-Weighted Imaging with Background Body Signal Suppression (DWIBS) Improves Pre-Therapeutical Detection of Early-Stage (pT1a) Glottic Cancer: A Feasibility and Interobserver Reliability Study. Diagnostics (Basel) 2022; 12:diagnostics12123200. [PMID: 36553207 PMCID: PMC9777074 DOI: 10.3390/diagnostics12123200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
(1) Background: Early-stage glottic cancer is easily missed on magnetic resonance imaging (MRI). Diffusion-weighted imaging (DWI) may improve diagnostic accuracy. Therefore, our aim was to assess the value of adding diffusion-weighted imaging with background body signal suppression (DWIBS) to pre-therapeutic MRI staging. (2) Methods: Two radiologists with 8 and 13 years of experience, blinded to each other's findings, initially interpreted only standard MRI, later DWIBS alone, and afterward, standard MRI + DWIBS in 41 patients with histopathologically proven pT1a laryngeal cancer of the glottis. (3) Results: Detectability rates with standard MRI, DWIBS only, and standard MRI + DWIBS were 68-71%, 63-66%, and 73-76%, respectively. Moreover, interobserver reliability was calculated as good (κ = 0.712), very good (κ = 0.84), and good (κ = 0.69) for standard MRI, DWIBS only, and standard MRI + DWIBS, respectively. (4) Conclusions: Standard MRI, DWIBS alone, and standard MRI + DWIBS showed an encouraging detection rate, as well as distinct interobserver reliability in the diagnosis of early-stage laryngeal cancer when compared to the definitive histopathologic report.
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Fiori T, Lisewski D, Flukes S, Wood C, Gibson D. Lessons learnt from the global iodinated contrast media shortage in head and neck imaging. J Med Imaging Radiat Oncol 2022; 66:1073-1083. [PMID: 36125131 DOI: 10.1111/1754-9485.13472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/05/2022] [Indexed: 11/27/2022]
Abstract
A recent shortage in the global supply of iodinated contrast media (ICM) has required health service providers to review their contrast administration policies and implement strategies to conserve inventory. This article will review the current best practices in head and neck imaging for a variety of common presentations and provide examples where alternative imaging can be considered due to the recent ICM shortage. Ultrasound and MRI techniques can feature heavily in many diagnostic processes in head and neck pathology, and a variety of common presentations can be appropriately investigated through clinical evaluation or naso-endoscopy. In many instances, for the routine assessment of non-acute adult and paediatric head and neck presentations, the use of contrast-enhanced CT can be safely minimised to conserve ICM if required.
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Affiliation(s)
- Timothy Fiori
- Department of Medical Imaging, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Dean Lisewski
- Department of General Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Stephanie Flukes
- Department of Otolaryngology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Chris Wood
- Department of Medical Imaging, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Daren Gibson
- Department of Medical Imaging, Fiona Stanley Hospital, Perth, Western Australia, Australia
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15
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Fermi M, Lo Manto A, Di Massa G, Gallo G, Lupi M, Maiolo V, Montrone G, Lovato L, Presutti L, Mattioli F. Paraglottic Space Invasion in Glottic Laryngeal Cancer: A Clinical‐Pathological Study. Laryngoscope 2022; 133:1184-1190. [PMID: 37042776 DOI: 10.1002/lary.30335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aims to prospectively compare endoscopic, radiological, and pathological features of a cohort of patients with glottic laryngeal squamous cell carcinoma (LSCC) undergoing open partial horizontal laryngectomy (OPHL) type II/III or total laryngectomy to better understand the reliability of preoperative endoscopy and computed tomography (CT) to predict the inferior paraglottic space (iPGS) involvement. METHODS We prospectively compared the endoscopic, radiological, and pathological findings in patients with glottic LSCC who underwent OPHL II/III, or total laryngectomy. RESULTS Endoscopy achieved a diagnostic accuracy of 87.2% for the anterior iPGS (iPGSa) and 86.1% for the posterior iPGS (iPGSp). There was no statistically significant difference in terms of histopathologic iPGSa involvement between reduced (85%-17/20 pts) and absent (92%-24/26 pts) vocal cord mobility (p = 0.39). CT alone did not improve the diagnostic performance of the endoscopy, reaching a diagnostic accuracy of 62.9% and 73.7% for the iPGSa and iPGSp, respectively. When endoscopy and CT were combined, the diagnostic performance improved for the iPGSp, achieving a sensitivity (Se), specificity (Spe), positive predictive value (PPV), and negative predictive value (NPV) of 100%, 89.8%, 68.7%, and 100%, respectively. On the contrary, the combination of CT and endoscopy improved only the Se and NPV for the iPGSa with respect to the sole endoscopic assessment. CONCLUSIONS Whenever motility impairment is present, a histopathologic invasion of the iPGS should be suspected. Endoscopic assessment of laryngeal motility achieved a satisfactory value of Se, Spe, PPV, and NPV in predicting the involvement of the iPGS. CT scan is still the mainstay imaging technique in the clinical staging of patients with LSCC. LEVEL OF EVIDENCE 4 Laryngoscope, 133:1184-1190, 2023.
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Affiliation(s)
- Matteo Fermi
- Department of Otorhinolaryngology, Head and Neck Surgery IRCCS Azienda Ospedaliero‐Universitaria di Bologna, Policlinico S.Orsola‐Malpighi Bologna Italy
- Department of Specialist, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum Università di Bologna Bologna Italy
| | - Alfredo Lo Manto
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital of Modena Modena Italy
| | | | - Graziana Gallo
- Department of Pathology University Hospital of Modena Modena Italy
| | - Massimo Lupi
- Department of Pathology University Hospital of Modena Modena Italy
| | - Vincenzo Maiolo
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna, Policlinico S.Orsola‐Malpighi Bologna Italy
| | - Grazia Montrone
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna, Policlinico S.Orsola‐Malpighi Bologna Italy
| | - Luigi Lovato
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna, Policlinico S.Orsola‐Malpighi Bologna Italy
| | - Livio Presutti
- Department of Otorhinolaryngology, Head and Neck Surgery IRCCS Azienda Ospedaliero‐Universitaria di Bologna, Policlinico S.Orsola‐Malpighi Bologna Italy
- Department of Specialist, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum Università di Bologna Bologna Italy
| | - Francesco Mattioli
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital of Modena Modena Italy
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16
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Abraham ZS, Zerd F, Kahinga AA. Advanced hypopharyngeal squamous cell carcinoma mimicking thyroid abscess in a young male: Case report and literature review. Int J Surg Case Rep 2022; 94:107154. [PMID: 35658311 PMCID: PMC9093012 DOI: 10.1016/j.ijscr.2022.107154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 10/26/2022] Open
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