Magnetic resonance imaging to assess cartilage invasion in recurrent laryngeal carcinoma after transoral laser microsurgery

Abstract

SUMMARY Objective To evaluate the diagnostic performance of magnetic resonance (MR) with surface coils in assessing cartilage invasion in recurrent laryngeal carcinoma after carbon dioxide transoral laser microsurgery (CO 2 TOLMS). Methods Two expert head and neck radiologists assessed cartilage invasion (infiltrated or non-infiltrated) in submucosal recurrences of laryngeal carcinoma after CO 2 TOLMS: results were compared with histopathological report after salvage laryngectomy. Results Thirty patients met the inclusion criteria and 90 cartilages were assessed. Overall sensitivity, specificity, and positive and negative predictive values for cartilage infiltration were 76, 93, 72 and 94%, respectively; for thyroid cartilage, the values were 82, 79, 69 and 88% respectively; for cricoid cartilage, all values were 100%; and for arytenoids, the values were 33, 96, 56 and 93% respectively. Conclusions MR with surface coils was able to detect most thyroid and cricoid infiltration in the complex setting of post-CO 2 TOLMS laryngeal carcinoma recurrence. In particular, the optimal performance in assessing cricoid invasion can be valuable in choosing the most appropriate treatment among total laryngectomy, open partial horizontal laryngectomies and non-surgical strategies.

Thyroid cartilage infiltration in advanced laryngeal cancer: prognostic implications and predictive modelling

“…The former efficiently detects cartilaginous invasions, but may fail to identify minor erosion due to varying degrees of cartilage ossification, potentially confounding the diagnosis 17,18 . MRI is more effective in diagnosis of cartilaginous infiltration, despite occasional difficulties in distinguishing it from peritumoural inflammation [19][20][21] . Despite the benefits of MRI, CT remains the most frequently employed diagnostic tool due to its widespread availability.…”