Abstract
The aim of this study was to evaluate the predictive value of magnetic resonance imaging (MRI) in detecting thyroid gland invasion (TGI) in patients with advanced laryngeal or hypopharyngeal carcinoma. In a retrospective chart review, 41 patients with advanced laryngeal or hypopharyngeal carcinoma underwent MRI scan before total laryngectomy and ipsilateral or bilateral thyroidectomy during the past 5 years. The MRI findings were compared with the postoperative pathological results. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Among the 41 patients, 3 had thyroid gland invasion in postoperative pathological results. MRI correctly predicted the absence of TGI in 37 of 38 patients and TGI in all 3 patients. The sensitivity, specificity, PPV, and NPV of MRI were 100.0, 97.4, 75.0, and 100 %, respectively, with the diagnostic accuracy of 97.6 %. In consideration of the high negative predictive value of MRI, it may help surgeons selectively preserve thyroid gland in total laryngectomy and reduce the incidence of hypothyroidism and hypoparathyroidism postoperatively.
Similar content being viewed by others
References
Kumar R, Drinnan M, Robinson M, Meikle D, Stafford F, Welch A, Zammit-Maempel I, Paleri V (2013) Thyroid gland invasion in total laryngectomy and total laryngopharyngectomy: a systematic review and meta-analysis of the English literature. Clin Otolaryngol Off J ENT-UK Off J Netherlands Soc Oto-Rhino-Laryngol Cerv-Fac Surg 38(5):372–378. doi:10.1111/coa.12165
Mendelson AA, Al-Khatib TA, Julien M, Payne RJ, Black MJ, Hier MP (2009) Thyroid gland management in total laryngectomy: meta-analysis and surgical recommendations. Otolaryngol-Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg 140(3):298–305. doi:10.1016/j.otohns.2008.10.031
Gurbuz MK, Acikalin M, Tasar S, Cakli H, Yorulmaz G, Erdinc M, Ozudogru E, Kecik C, Colak E, Saylisoy S (2014) Clinical effectiveness of thyroidectomy on the management of locally advanced laryngeal cancer. Auris Nasus Larynx 41(1):69–75. doi:10.1016/j.anl.2013.10.004
Mourad M, Saman M, Sawhney R, Ducic Y (2015) Management of the thyroid gland during total laryngectomy in patients with laryngeal squamous cell carcinoma. Laryngosc 125(8):1835–1838. doi:10.1002/lary.25263
Ortega-Gutierrez C, Luna-Ortiz K, Villavicencio-Valencia V, Herrera Gomez A, Tellez-Palacios D, Contreras-Buendia M (2012) Hypothyroidism incidence after multimodal treatment for laryngeal cancer. Cir Cir 80(5):448–450
Osborn DA, Jones WI (1968) Parathyroid dysfunction following surgery of the pharynx and larynx. Br J Surg 55(4):277–282
Thorp MA, Levitt NS, Mortimore S, Isaacs S (1999) Parathyroid and thyroid function 5 years after treatment of laryngeal and hypopharyngeal carcinoma. Clin Otolaryngol Allied Sci 24(2):104–108
Brennan JA, Meyers AD, Jafek BW (1991) The intraoperative management of the thyroid gland during laryngectomy. Laryngosc 101(9):929–934. doi:10.1288/00005537-199109000-00003
Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64(1):9–29. doi:10.3322/caac.21208
Howlader NNA, Krapcho M, Neyman N, Aminou R, Waldron W, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA, Edwards BK (eds). SEER Cancer Statistics Review, 1975–2008. National Cancer Institute Bethesda, MD, http://www.seercancergov/csr/1975_2008/, based on November 2010 SEER data submission, posted to the SEER web site, 2011
Newman JR, Connolly TM, Illing EA, Kilgore ML, Locher JL, Carroll WR (2015) Survival trends in hypopharyngeal cancer: a population-based review. Laryngosc 125(3):624–629. doi:10.1002/lary.24915
Koo BS, Lim YC, Lee JS, Kim YH, Kim SH, Choi EC (2006) Management of contralateral N0 neck in pyriform sinus carcinoma. Laryngosc 116(7):1268–1272. doi:10.1097/01.mlg.0000225936.88411.71
Kinshuck AJ, Goodyear PW, Lancaster J, Roland NJ, Jackson S, Hanlon R, Lewis-Jones H, Sheard J, Jones TM (2012) Accuracy of magnetic resonance imaging in diagnosing thyroid cartilage and thyroid gland invasion by squamous cell carcinoma in laryngectomy patients. J Laryngol Otol 126(3):302–306. doi:10.1017/s0022215111003331
Leon X, Gras JR, Perez A, Rodriguez J, de Andres L, Orus C, Quer M (2002) Hypothyroidism in patients treated with total laryngectomy. A multivariate study. Euro Arch Oto-Rhino-Laryngol Off J Euro Feder Oto-Rhino-Laryngol Soc (EUFOS): Affil German Soc Oto-Rhino-Laryngol-Head Neck Surg 259(4):193–196
Ho AC, Ho WK, Lam PK, Yuen AP, Wei WI (2008) Thyroid dysfunction in laryngectomees-10 years after treatment. Head Neck 30(3):336–340. doi:10.1002/hed.20693
Mortimore S, Thorp MA, Nilssen EL, Isaacs S (1998) Hypoparathyroidism after the treatment of laryngopharyngeal carcinoma. J Laryngol Otol 112(11):1058–1060
Baugnon KL, Beitler JJ (2013) Pitfalls in the staging of cancer of the laryngeal squamous cell carcinoma. Neuroimaging Clin N Am 23(1):81–105. doi:10.1016/j.nic.2012.08.008
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Research involving human participants
Medical chart review.
Informed consent
For this type of study, formal consent is not required.
Rights and permissions
About this article
Cite this article
Lin, P., Huang, X., Zheng, C. et al. The predictive value of MRI in detecting thyroid gland invasion in patients with advanced laryngeal or hypopharyngeal carcinoma. Eur Arch Otorhinolaryngol 274, 361–366 (2017). https://doi.org/10.1007/s00405-016-4258-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-016-4258-0