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Title

Neoplastic invasion of laryngeal cartilage: reassessment of criteria for diagnosis at MR imaging

Authors
Zbären, Peter
Casselman, Jan Walther
Kohler, Romain
Published in Radiology. 2008, vol. 249, no. 2, p. 551-9
Abstract PURPOSE: To evaluate whether proposed diagnostic criteria applied to magnetic resonance (MR) images of patients with laryngeal and hypopharyngeal carcinoma may be used to distinguish neoplastic from inflammatory involvement of the laryngeal cartilages. MATERIALS AND METHODS: The radiologic and histopathologic data in 121 consecutive patients with primary squamous cell carcinoma of the larynx (n = 63) or hypopharynx (n = 58) who underwent MR imaging before laryngectomy formed the basis of this retrospective study. Patient consent for retrospective chart review was waived by the institutional review board. All laryngectomy specimens were processed with a dedicated histopathologic whole-organ slice technique. MR images were evaluated by two readers according to established ("old") and proposed ("new") diagnostic criteria on the basis of the signal intensity behavior of cartilage on T2-weighted images and contrast material-enhanced T1-weighted images compared with that of the adjacent tumor. Specifically, with the new criteria, T2-weighted or postcontrast T1-weighted cartilage signal intensity greater than that of the adjacent tumor was considered to indicate inflammation, and signal intensity similar to that of the adjacent tumor was considered to indicate neoplastic invasion. The results of the MR image interpretation were compared with the histologic reference standard. RESULTS: The area under the receiver operating characteristic curve for the new criteria (0.94) was nominally but significantly larger than that for the old criteria (0.92) (P =.01). Overall specificity was significantly improved (82% for new vs 74% for old criteria, P <.001) and was greatest for the thyroid cartilage (75% for new vs 54% for old criteria, P <.001) with the new criteria. The sensitivities of the established and the proposed criteria were identical. CONCLUSION: The proposed MR imaging criteria enable improved differentiation of neoplastic cartilage invasion from peritumoral inflammation.
Keywords AdultAgedAged, 80 and overCarcinoma, Squamous Cell/pathologyContrast MediaFemaleHumansHypopharyngeal Neoplasms/pathology/surgeryLaryngeal Cartilages/pathology/surgeryLaryngeal Neoplasms/pathology/surgeryMagnetic Resonance Imaging/methodsMaleMiddle AgedNeoplasm InvasivenessROC CurveRetrospective Studies
Stable URL http://archive-ouverte.unige.ch/unige:1398
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Identifiers
PMID: 18936314
Structures
Research groups Groupe Dulguerov Pavel (ORL et chirurgie cervico-faciale) (145)
Imagerie et radiologie interventionnelle du foie, des voies biliaires et du pancréas (316)
Groupe Becker Minerva (imagerie ORL) (683)

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Deposited on : 2009-04-27

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