Utility of positron‐emission tomography/computed tomography imaging in the management of the neck in recurrent laryngeal cancer

Gilbert, Mark R.; Branstetter, Barton F.; Kim, Seungwon

doi:10.1002/lary.22428

Cited by 21 publications

(18 citation statements)

References 21 publications

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“…However, (chondro)radionecrosis and recurrent tumor may coexist. Fluorodeoxyglucose positron emission tomography has a high negative predictive value but is burdened with a high number of false positives [21][22][23]. DWI has the potential to differentiate radionecrosis and tumor recurrence [24] although -occasionally -fungal infection, pus, and dense necrotic debris along the walls of ulcerated lesions may cause signal restriction leading to false positive interpretation.…”

Section: Magnetic Resonance In the Follow-up Of The Treated Laryngealmentioning

confidence: 98%

Magnetic resonance for laryngeal cancer

Maroldi

Ravanelli

Farina

2014

Current Opinion in Otolaryngology & Head and Neck Surgery

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Purpose of reviewThis review summarizes the most recent experiences on the integration of magnetic resonance in assessing the local extent of laryngeal cancer and detecting submucosal recurrences. Recent findingsAdvances in magnetic resonance have been characterized by the development of technical solutions that shorten the acquisition time, thereby reducing motion artifacts, and increase the spatial resolution. Phasedarray surface coils, directly applied to the neck, enable the use of parallel-imaging techniques, which greatly reduce the acquisition time, and amplify the signal intensity, being closer to the larynx. One of the most important drawbacks of this technique is the small field-of-view, restricting the imaged area to the larynx. Furthermore, diffusion-weighted imaging (DWI) has increased the set of magnetic resonance sequences. Differently from computed tomography (CT), which has only two variables (precontrast/ postcontrast), magnetic resonance is based on a multiparameter analysis (T2-weighting and T1-weighting, DWI, and postcontrast acquisition). This multiparameter approach amplifies the contrast resolution. It has, also, permitted to differentiate scar tissue (after laser resection) from submucosal recurrent disease. In addition, DWI sequences have the potential of a more precise discrimination of peritumoral edema from neoplastic tissue, which may lead to improve the assessment of paraglottic space invasion. SummaryMagnetic resonance of the larynx is technically challenging. The use of surface coils and motion-reducing techniques is critical to achieve adequate image quality. The intrinsic high-contrast resolution is further increased by the integration of information from different sequences. When CT has not been conclusive, magnetic resonance is indicated in the pretreatment local assessment and in the suspicion of submucosal recurrence.

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Section: Magnetic Resonance In the Follow-up Of The Treated Laryngealmentioning

confidence: 98%

Magnetic resonance for laryngeal cancer

Maroldi

Ravanelli

Farina

2014

Current Opinion in Otolaryngology & Head and Neck Surgery

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“…Additionally, PET‐CT is increasingly used to improve the accuracy of staging in recurrent laryngeal cancer . Although the ability of PET‐CT to detect nodal metastasis in other tumors has been addressed, the predictive value of PET‐CT in detecting nodal disease in patients with recurrent laryngeal cancer has not been well studied . The purpose of this study was to evaluate the predictive value of PET‐CT in identifying nodal metastasis in patients with recurrent laryngeal carcinoma with a clinically and radiographically N0 neck.…”

Section: Introductionmentioning

confidence: 99%

“…30 Although the ability of PET-CT to detect nodal metastasis in other tumors has been addressed, the predictive value of PET-CT in detecting nodal disease in patients with recurrent laryngeal cancer has not been well studied. 15,16,21,[29][30][31][32][33][34][35][36][37] The purpose of this study was to evaluate the predictive value of PET-CT in identifying nodal metastasis in patients with recurrent laryngeal carcinoma with a clinically and radiographically N0 neck. The overall goal was to assess the ability of PET-CT to discriminate the need for elective neck dissection.…”

Section: Introductionmentioning

confidence: 99%

Positron emission tomography–CT prediction of occult nodal metastasis in recurrent laryngeal cancer

et al. 2017

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Background The objective of this study was to evaluate the predictive value of PET-CT in identifying occult nodal metastasis in clinically and radiographically N0 patients with recurrent laryngeal cancer undergoing salvage laryngectomy. Methods Retrospective review of 46 clinically and radiographically N0 patients with recurrent laryngeal cancer who underwent a PET-CT examination prior to salvage laryngectomy with neck dissection from January 1, 2002 to December 31, 2014 was performed. Results Two patients (16.7%) had true positive PET-CT results, while 10 patients (83.3%) had false negative scans, one patient(2.9%) had a false positive result and 33 patients (97.1%) had a true negative PET-CT. The sensitivity of PET-CT was 16.7% (95% CI, 3.5% – 46.0%) with a specificity of 97.1% (95% CI, 83.8% – 99.9%), positive predictive value (PPV) of 66.7% (95% CI, 20.2% – 94.4%) and negative predictive value (NPV) of 76.7% (95% CI, 62.1% – 87.0%). Conclusions PET-CT has poor sensitivity and NPV making PET-CT an imperfect predictor of nodal disease in recurrent laryngeal cancer.

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“…If the findings are negative, they undergo CECT alone 6 months later, and if these findings are negative, they undergo CECT alone 12 months later. Although studies have investigated PET/CT for surveillance, [7][8][9] ordering practices among treating physicians remain variable. The 2015 National Comprehensive Cancer Network recommendations advocate imaging within 6 months for T3/4 primary tumors or N2/3 nodal disease and then additional imaging only for new signs/symptoms, smoking, or areas inaccessible to clinical inspection (the latter being arbitrary and difficult to apply).…”

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confidence: 99%

Initial Performance of NI-RADS to Predict Residual or Recurrent Head and Neck Squamous Cell Carcinoma

Krieger

Rhyner²,

Nayak

et al. 2017

AJNR Am J Neuroradiol

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Utility of positron‐emission tomography/computed tomography imaging in the management of the neck in recurrent laryngeal cancer

Abstract: We believe that this false negative rate is too high to warrant deferring neck dissection based on PET/CT, and we recommend that patients who are clinically N0 for recurrent laryngeal cancer be offered neck dissection along with salvage laryngectomy.

Cited by 21 publications

References 21 publications

Magnetic resonance for laryngeal cancer

Magnetic resonance for laryngeal cancer

Positron emission tomography–CT prediction of occult nodal metastasis in recurrent laryngeal cancer

Initial Performance of NI-RADS to Predict Residual or Recurrent Head and Neck Squamous Cell Carcinoma

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