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Early glottic cancer: role of MRI in the preoperative staging.

Allegra E, Ferrise P, Trapasso S, Trapuzzano O, Barca A, Tamburrini S, Garozzo A - Biomed Res Int (2014)

Bottom Line: The results of MRI and CT were compared with each other and with the pathology report.Statistical analysis showed that MRI has higher correlation than CT with the pathology report.Our study showed that MRI is more sensitive than CT in the preoperative staging of early glottic cancer, to select exactly the eligible patients in conservative surgery of the larynx, as supracricoid laryngectomy and cordectomy by CO2 laser.

View Article: PubMed Central - PubMed

Affiliation: Department of Experimental and Clinical Medicine-Otolaryngology Head and Neck Surgery, University of Catanzaro, Viale Europa, Località Germaneto, 88100 Catanzaro, Italy.

ABSTRACT

Introduction: Clinical staging is the most important time in management of glottic cancer in early stage (I-II). We have conducted a prospective study to evaluate if magnetic resonance imaging (MRI) is more accurate than computed tomography (CT) about tumoral extension, to exactly choose the most appropriate surgical approach, from organ preservation surgery to demolitive surgery. MATERIALS and

Methods: This prospective study was conducted on 26 male patients, with suspected laryngeal neoplasia of glottic region. The images of MRI and CT were analyzed to define the expansion of glottic lesion to anterior commissure, laryngeal cartilages, subglottic and/or supraglottic site, and paraglottic space. The results of MRI and CT were compared with each other and with the pathology report.

Results: CT accuracy was 70% with low sensitivity but with high specific value. MRI showed a diagnostic accuracy in 80% of cases, with a sensitivity of 100% and high specificity. Statistical analysis showed that MRI has higher correlation than CT with the pathology report.

Conclusion: Our study showed that MRI is more sensitive than CT in the preoperative staging of early glottic cancer, to select exactly the eligible patients in conservative surgery of the larynx, as supracricoid laryngectomy and cordectomy by CO2 laser.

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Bilateral glottic carcinoma with involvement of anterior commissure: (a) endoscopic view; (b) CT image: contrast enhancement of right vocal fold, but the commissure seems preserved (green indicator); (c) T1w MR image after contrast shows involvement of right true vocal cord, anterior commissure, and anterior part of left vocal fold (green indicator).
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fig2: Bilateral glottic carcinoma with involvement of anterior commissure: (a) endoscopic view; (b) CT image: contrast enhancement of right vocal fold, but the commissure seems preserved (green indicator); (c) T1w MR image after contrast shows involvement of right true vocal cord, anterior commissure, and anterior part of left vocal fold (green indicator).

Mentions: CT classified in a correct way 14 of 20 patients (70%), with six understaged patients: two lesions classified as cT1a by CT were pT1b, two lesions classified as cT1a were pT3, and two tumors were not detected by CT examination. The two cases of squamous cell papillomas were interpreted in a correct way. About the examination of anterior commissure, laryngeal cartilages and paraglottic space, CT has been shown to be a little sensitive method (40%), with eight false negatives (Figures 1 and 2) but with high specificity (100%), as calculated from the data in Table 2.


Early glottic cancer: role of MRI in the preoperative staging.

Allegra E, Ferrise P, Trapasso S, Trapuzzano O, Barca A, Tamburrini S, Garozzo A - Biomed Res Int (2014)

Bilateral glottic carcinoma with involvement of anterior commissure: (a) endoscopic view; (b) CT image: contrast enhancement of right vocal fold, but the commissure seems preserved (green indicator); (c) T1w MR image after contrast shows involvement of right true vocal cord, anterior commissure, and anterior part of left vocal fold (green indicator).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150401&req=5

fig2: Bilateral glottic carcinoma with involvement of anterior commissure: (a) endoscopic view; (b) CT image: contrast enhancement of right vocal fold, but the commissure seems preserved (green indicator); (c) T1w MR image after contrast shows involvement of right true vocal cord, anterior commissure, and anterior part of left vocal fold (green indicator).
Mentions: CT classified in a correct way 14 of 20 patients (70%), with six understaged patients: two lesions classified as cT1a by CT were pT1b, two lesions classified as cT1a were pT3, and two tumors were not detected by CT examination. The two cases of squamous cell papillomas were interpreted in a correct way. About the examination of anterior commissure, laryngeal cartilages and paraglottic space, CT has been shown to be a little sensitive method (40%), with eight false negatives (Figures 1 and 2) but with high specificity (100%), as calculated from the data in Table 2.

Bottom Line: The results of MRI and CT were compared with each other and with the pathology report.Statistical analysis showed that MRI has higher correlation than CT with the pathology report.Our study showed that MRI is more sensitive than CT in the preoperative staging of early glottic cancer, to select exactly the eligible patients in conservative surgery of the larynx, as supracricoid laryngectomy and cordectomy by CO2 laser.

View Article: PubMed Central - PubMed

Affiliation: Department of Experimental and Clinical Medicine-Otolaryngology Head and Neck Surgery, University of Catanzaro, Viale Europa, Località Germaneto, 88100 Catanzaro, Italy.

ABSTRACT

Introduction: Clinical staging is the most important time in management of glottic cancer in early stage (I-II). We have conducted a prospective study to evaluate if magnetic resonance imaging (MRI) is more accurate than computed tomography (CT) about tumoral extension, to exactly choose the most appropriate surgical approach, from organ preservation surgery to demolitive surgery. MATERIALS and

Methods: This prospective study was conducted on 26 male patients, with suspected laryngeal neoplasia of glottic region. The images of MRI and CT were analyzed to define the expansion of glottic lesion to anterior commissure, laryngeal cartilages, subglottic and/or supraglottic site, and paraglottic space. The results of MRI and CT were compared with each other and with the pathology report.

Results: CT accuracy was 70% with low sensitivity but with high specific value. MRI showed a diagnostic accuracy in 80% of cases, with a sensitivity of 100% and high specificity. Statistical analysis showed that MRI has higher correlation than CT with the pathology report.

Conclusion: Our study showed that MRI is more sensitive than CT in the preoperative staging of early glottic cancer, to select exactly the eligible patients in conservative surgery of the larynx, as supracricoid laryngectomy and cordectomy by CO2 laser.

Show MeSH
Related in: MedlinePlus