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Current role of computed tomography imaging in the evaluation of cartilage invasion by laryngeal carcinoma

  • HEAD, NECK AND DENTAL RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Objectives

To evaluate thyroid, arytenoid, and cricoid cartilage invasion on computed tomography (CT) imaging in patients undergoing total laryngectomy for both primary and recurrent laryngeal carcinoma. Secondary endpoint was to compare laryngeal cartilage invasion between primary and recurrent tumours.

Methods

Pre-treatment CT of 40 patients who had undergone total laryngectomy was retrospectively evaluated and compared with histology. Focal erosions of thyroid cartilage were accounted for neoplastic invasion of the inner cortex. Full-thickness thyroid cartilage invasion was defined as a tumour-like tissue replacing thyroid cartilage or extended in extra-laryngeal soft tissues. Sclerosis and erosion of arytenoid and cricoid cartilages were assessed as signs of neoplastic invasion.

Results

CT erosion showed perfect agreement for thyroid inner cortex and cricoid cartilage invasion and almost perfect agreement (87%) for arytenoid cartilage invasion. For tumours in contact with thyroid cartilages, the absence of CT erosion underestimated inner cortex infiltration. CT showed perfect agreement in predicting full-thickness thyroid cartilage invasion only in the case of extra-laryngeal neoplastic extension. Arytenoid sclerosis showed poor correlation with neoplastic invasion. For primary tumours, CT demonstrated good (inner cortex 75%; full-thickness 85%), substantial (67.5%), and perfect (100%) accuracy in thyroid, arytenoid, and cricoid cartilage invasion, respectively. No CT differences were observed between primary and recurrent laryngeal tumours.

Conclusion

Tumour-like tissue extension in the extra-laryngeal soft tissues was accurate in predicting thyroid cartilage full-thickness invasion. Erosions of arytenoid, cricoid, and thyroid cartilages’ inner cortex on CT were highly indicative of neoplastic infiltration. No CT difference in cartilage infiltration between primary and recurrent tumours was observed.

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Acknowledgement

The authors have no financial affiliation (employment, direct payment, stock holdings, retainers, consultantships, patent licensing arrangements, or honoraria) or involvement with any commercial organization with direct financial interest in the subject or materials discussed in this manuscript, nor have any such arrangements existed in the past 3 years.

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Authors and Affiliations

  1. Radiodiagnostic Unit n. 2, Department of Experimental and Clinical Biomedical Sciences, Careggi University Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Michele Pietragalla, Cosimo Nardi & Linda Calistri

  2. Department of Radiology, Careggi University Hospital, Viale Morgagni 85, 50134, Florence, Italy

    Luigi Bonasera, Francesco Mungai, Giovanni Battista Verrone & Vittorio Miele

  3. Department of Surgery and Translational Medicine, Institute of Pathology, Careggi University Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Cecilia Taverna & Luca Novelli

  4. Department of Otorhinolaryngology, Careggi University Hospital, Viale Morgagni 85, 50134, Florence, Italy

    Luca Giovanni Locatello & Oreste Gallo

  5. Head and Neck Oncology and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Giuditta Mannelli

Authors
  1. Michele Pietragalla
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  2. Cosimo Nardi
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  3. Luigi Bonasera
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  7. Cecilia Taverna
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  9. Luca Giovanni Locatello
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Correspondence to Michele Pietragalla.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Pietragalla, M., Nardi, C., Bonasera, L. et al. Current role of computed tomography imaging in the evaluation of cartilage invasion by laryngeal carcinoma. Radiol med 125, 1301–1310 (2020). https://doi.org/10.1007/s11547-020-01213-y

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  • DOI: https://doi.org/10.1007/s11547-020-01213-y

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