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New Developments in Imaging of Laryngeal Cancer

  • Head and Neck: Laryngeal Cancer (C Piazza, Section Editor)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To critically review the recent literature about laryngeal cancer imaging using a clinically oriented perspective and focusing on technical innovations.

Recent Findings

A number of articles have been recently published on cartilage invasion assessment. Inaccuracy of CT in assessing major cartilage invasion and extralaryngeal spread has emerged. Imaging of paraglottic and preepiglottic space invasion has been less investigated. MR can outperform CT, but optimization of MR protocols is crucial. Dual-energy/spectral CT and diffusion-weighted MR are promising techniques, but their clinical utility needs to be confirmed. Tumor volume is usually overestimated with CT and MR compared to that of histopathology. Follow-up, especially after (chemo) radiation, is challenging, and MR with diffusion-weighted sequences seems superior to CT in discriminating recurrence from inflammatory changes.

Summary

CT is a well-established technique, with known limitations. MR potential needs to be exploited using a state-of-the-art technique. Specific relevant issues for planning mini invasive surgery need to be further investigated.

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References

Papers of particular interest, published recently, have been highlighted as:• Of importance •• Of major importance

  1. Li A, Liang H, Li W, et al. Spectral CT imaging of laryngeal and hypopharyngeal squamous cell carcinoma: evaluation of image quality and status of lymph nodes. PLoS One. 2013;8(12):e83492. doi:10.1371/journal.pone.0083492.

    Article  PubMed  PubMed Central  Google Scholar 

  2. • Kuno H, Onaya H, Iwata R, et al. Evaluation of cartilage invasion by laryngeal and hypopharyngeal squamous cell carcinoma with dual-energy CT. Radiology. 2012;265(2):488–96. doi:10.1148/radiol.12111719. new developments: iodinated maps derived from dual-energy CT helps to assess cartilage invasion

    Article  PubMed  Google Scholar 

  3. • Forghani R, Levental M, Gupta R, Lam S, Dadfar N, Curtin HD. Different spectral hounsfield unit curve and high-energy virtual monochromatic image characteristics of squamous cell carcinoma compared with nonossified thyroid cartilage. AJNR Am J Neuroradiol. 2015;36(6):1194–200. doi:10.3174/ajnr.A4253. new developments: spectral CT helps to differentiate nonossified cartilage from cancer

    Article  CAS  PubMed  Google Scholar 

  4. •• Ravanelli M, Farina D, Rizzardi P, et al. MR with surface coils in the follow-up after endoscopic laser resection for glottic squamous cell carcinoma: feasibility and diagnostic accuracy. Neuroradiology. 2013;55(2):225–32. doi:10.1007/s00234-012-1128-3. MRI with surface coils is the gold-standard for larynx assessment after laser surgery

    Article  PubMed  Google Scholar 

  5. Casselman JW. High-resolution imaging of the Skull Base and larynx. In: Schoenberg SO, Dietrich O, Reiser MF, editors. Parallel imaging in clinical MR applications. Berlin, Heidelberg: Springer Berlin Heidelberg; 2007. p. 199–208 .http://link.springer.com/10.1007/978-3-540-68879-2_19. Accessed November 23, 2016

    Chapter  Google Scholar 

  6. Verduijn GM, Bartels LW, Raaijmakers CPJ, Terhaard CHJ, Pameijer FA, van den Berg CAT. Magnetic resonance imaging protocol optimization for delineation of gross tumor volume in hypopharyngeal and laryngeal tumors. Int J Radiat Oncol Biol Phys. 2009;74(2):630–6. doi:10.1016/j.ijrobp.2009.01.014.

    Article  PubMed  Google Scholar 

  7. Ljumanovic R, Langendijk JA, van Wattingen M, et al. MR imaging predictors of local control of glottic squamous cell carcinoma treated with radiation alone. Radiology. 2007;244(1):205–12. doi:10.1148/radiol.2441060593.

    Article  PubMed  Google Scholar 

  8. Banko B, Dukić V, Milovanović J, Kovač JD, Artiko V, Maksimović R. Diagnostic significance of magnetic resonance imaging in preoperative evaluation of patients with laryngeal tumors. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2011;268(11):1617–23. doi:10.1007/s00405-011-1701-0.

    Google Scholar 

  9. Becker M, Zbären P, Casselman JW, Kohler R, Dulguerov P, Becker CD. Neoplastic invasion of laryngeal cartilage: reassessment of criteria for diagnosis at MR imaging. Radiology. 2008;249(2):551–9. doi:10.1148/radiol.2492072183.

    Article  PubMed  Google Scholar 

  10. Taha MS, Hassan O, Amir M, Taha T, Riad MA. Diffusion-weighted MRI in diagnosing thyroid cartilage invasion in laryngeal carcinoma. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2014;271(9):2511–6. doi:10.1007/s00405-013-2782-8.

    Google Scholar 

  11. Allegra E, Ferrise P, Trapasso S, et al. Early glottic cancer: role of MRI in the preoperative staging. Biomed Res Int. 2014;2014:890385. doi:10.1155/2014/890385.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kinshuck AJ, Goodyear PWA, Lancaster J, et al. Accuracy of magnetic resonance imaging in diagnosing thyroid cartilage and thyroid gland invasion by squamous cell carcinoma in laryngectomy patients. J Laryngol Otol. 2012;126(3):302–6. doi:10.1017/S0022215111003331.

    Article  CAS  PubMed  Google Scholar 

  13. •• Wu J-H, Zhao J, Li Z-H, et al. Comparison of CT and MRI in diagnosis of laryngeal carcinoma with anterior vocal commissure involvement. Sci Rep. 2016;6:30353. doi:10.1038/srep30353. MR superior than CT in staging anterior commissure cancer

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Maroldi R, Ravanelli M, Farina D. Magnetic resonance for laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg. 2014;22(2):131–9. doi:10.1097/MOO.0000000000000036.

    Article  PubMed  Google Scholar 

  15. Ohgiya Y, Suyama J, Seino N, et al. MRI of the neck at 3 Tesla using the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) (BLADE) sequence compared with T2-weighted fast spin-echo sequence. J Magn Reson Imaging JMRI. 2010;32(5):1061–7. doi:10.1002/jmri.22234.

    Article  PubMed  Google Scholar 

  16. Wu X, Raz E, Block TK, et al. Contrast-enhanced radial 3D fat-suppressed T1-weighted gradient-recalled Echo sequence versus conventional fat-suppressed contrast-enhanced T1-weighted studies of the head and neck. Am J Roentgenol. 2014;203(4):883–9. doi:10.2214/AJR.13.11729.

    Article  Google Scholar 

  17. Li B, Bobinski M, Gandour-Edwards R, Farwell DG, Chen AM. Overstaging of cartilage invasion by multidetector CT scan for laryngeal cancer and its potential effect on the use of organ preservation with chemoradiation. Br J Radiol. 2011;84(997):64–9. doi:10.1259/bjr/66700901.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Pfister DG. American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol. 2006;24(22):3693–704. doi:10.1200/JCO.2006.07.4559.

    Article  PubMed  Google Scholar 

  19. Beitler JJ, Muller S, Grist WJ, et al. Prognostic accuracy of computed tomography findings for patients with laryngeal cancer undergoing laryngectomy. J Clin Oncol Off J Am Soc Clin Oncol. 2010;28(14):2318–22. doi:10.1200/JCO.2009.24.7544.

    Article  Google Scholar 

  20. •• Ryu IS, Lee JH, Roh J-L, et al. Clinical implication of computed tomography findings in patients with locally advanced squamous cell carcinoma of the larynx and hypopharynx. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2015;272(10):2939–45. doi:10.1007/s00405-014-3249-2. Lack of sensitivity of CT in assessing thyroid cartilage penetration and extralaryngeal spread

    Google Scholar 

  21. Xia C-X, Zhu Q, Zhao H-X, Yan F, Li S-L, Zhang S-M. Usefulness of ultrasonography in assessment of laryngeal carcinoma. Br J Radiol. 2013;86(1030):20130343. doi:10.1259/bjr.20130343.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Adolphs APJ, Boersma NA, Diemel BDM, et al. A systematic review of computed tomography detection of cartilage invasion in laryngeal carcinoma. Laryngoscope. 2015;125(7):1650–5.

    Article  PubMed  Google Scholar 

  23. 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 Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2016; doi:10.1007/s00405-016-4120-4.

    Google Scholar 

  24. • Hartl DM, Landry G, Bidault F, et al. CT-scan prediction of thyroid cartilage invasion for early laryngeal squamous cell carcinoma. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2013;270(1):287–91. doi:10.1007/s00405-012-2005-8. Inaccuracy of CT in assessing minor cartilage invasion

    Google Scholar 

  25. •• Prades J-M, Gavid M, Dumollard J-M, Timoshenko A-T, Karkas A, Peoc’h M. Anterior laryngeal commissure: histopathologic data from supracricoid partial laryngectomy. Eur Ann Otorhinolaryngol Head Neck Dis. 2016;133(1):27–30. doi:10.1016/j.anorl.2015.08.017. CT is often unable to detect cartilage invasion in anterior commissure cancer

    Article  PubMed  Google Scholar 

  26. Rutkowski T. Impact of initial tumor volume on radiotherapy outcome in patients with T2 glottic cancer. Strahlenther Onkol Organ Dtsch Rontgengesellschaft Al. 2014;190(5):480–4. doi:10.1007/s00066-014-0603-7.

    Article  CAS  Google Scholar 

  27. van Bockel LW, Monninkhof EM, Pameijer FA, Terhaard CHJ. Importance of tumor volume in supraglottic and glottic laryngeal carcinoma. Strahlenther Onkol Organ Dtsch Rontgengesellschaft Al. 2013;189(12):1009–14. doi:10.1007/s00066-013-0467-2.

    Article  Google Scholar 

  28. Timmermans AJ, Lange CAH, de Bois JA, et al. Tumor volume as a prognostic factor for local control and overall survival in advanced larynx cancer. Laryngoscope. 2016;126(2):E60–7. doi:10.1002/lary.25567.

    Article  PubMed  Google Scholar 

  29. Janssens GO, van Bockel LW, Doornaert PA, et al. Computed tomography-based tumour volume as a predictor of outcome in laryngeal cancer: results of the phase 3 ARCON trial. Eur J Cancer Oxf Engl 1990. 2014;50(6):1112–9. doi:10.1016/j.ejca.2013.12.012.

    Google Scholar 

  30. Caldas-Magalhaes J, Kasperts N, Kooij N, et al. Validation of imaging with pathology in laryngeal cancer: accuracy of the registration methodology. Int J Radiat Oncol Biol Phys. 2012;82(2):e289–98. doi:10.1016/j.ijrobp.2011.05.004.

    Article  PubMed  Google Scholar 

  31. Jager EA, Ligtenberg H, Caldas-Magalhaes J, et al. Validated guidelines for tumor delineation on magnetic resonance imaging for laryngeal and hypopharyngeal cancer. Acta Oncol Stockh Swed. 2016:1–8. doi:10.1080/0284186X.2016.1219048.

  32. Hermans R, Pameijer FA, Mancuso AA, Parsons JT, Mendenhall WM. Laryngeal or hypopharyngeal squamous cell carcinoma: can follow-up CT after definitive radiation therapy be used to detect local failure earlier than clinical examination alone? Radiology. 2000;214(3):683–7. doi:10.1148/radiology.214.3.r00fe13683.

    Article  CAS  PubMed  Google Scholar 

  33. Sullivan BP, Parks KA, Dean NR, Rosenthal EL, Carroll WR, Magnuson JS. Utility of CT surveillance for primary site recurrence of squamous cell carcinoma of the head and neck. Head Neck. 2011;33(11):1547–50. doi:10.1002/hed.21636.

    Article  PubMed  Google Scholar 

  34. Bae JS, Roh J-L, Lee S, et al. Laryngeal edema after radiotherapy in patients with squamous cell carcinomas of the larynx and hypopharynx. Oral Oncol. 2012;48(9):853–8. doi:10.1016/j.oraloncology.2012.02.023.

    Article  PubMed  Google Scholar 

  35. • Han MW, Kim S-A, Cho K-J, et al. Diagnostic accuracy of computed tomography findings for patients undergoing salvage total laryngectomy. Acta Otolaryngol (Stockh). 2013;133(6):620–5. doi:10.3109/00016489.2012.761352. Inaccuracy of CT in assessing extent of recurrences after (chemo) radiation

    Article  Google Scholar 

  36. Tshering Vogel DW, Zbaeren P, Geretschlaeger A, Vermathen P, De Keyzer F, Thoeny HC. Diffusion-weighted MR imaging including bi-exponential fitting for the detection of recurrent or residual tumour after (chemo) radiotherapy for laryngeal and hypopharyngeal cancers. Eur Radiol. 2013;23(2):562–9. doi:10.1007/s00330-012-2596-x.

    Article  PubMed  Google Scholar 

  37. Vandecaveye V, Dirix P, De Keyzer F, et al. Diffusion-weighted magnetic resonance imaging early after chemoradiotherapy to monitor treatment response in head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2012;82(3):1098–107. doi:10.1016/j.ijrobp.2011.02.044.

    Article  PubMed  Google Scholar 

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Correspondence to Marco Ravanelli.

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Marco Ravanelli, Giorgio Maria Agazzi, Davide Farina, and Roberto Maroldi declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Head and Neck: Laryngeal Cancer

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Ravanelli, M., Agazzi, G.M., Farina, D. et al. New Developments in Imaging of Laryngeal Cancer. Curr Otorhinolaryngol Rep 5, 49–55 (2017). https://doi.org/10.1007/s40136-017-0145-5

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  • DOI: https://doi.org/10.1007/s40136-017-0145-5

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