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ISSN: Print -2349-0977, Online - 2349-4387
ORIGINAL CONTRIBUTION - ENT ONCOLOGY
Year : 2016  |  Volume : 2  |  Issue : 4  |  Page : 172-178

Role of computed tomography, magnetic resonance imaging, and endoscopy in pretherapeutic evaluation of laryngeal tumors


Department of Otorhinolaryngology, Dr. Ram Manohar Lohia Hospital, New Delhi, India

Correspondence Address:
Aniruddha Sarkar
Dr. Ram Manohar Lohia Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2349-0977.191045

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Purpose: We aimed to evaluate the efficacy of staging of laryngeal tumors by clinical and radiological parameters and role of computed tomography (CT) and magnetic resonance imaging (MRI) in the detection of cartilage invasion. We have done a randomized, cross-sectional study. Materials and Methods: The study comprised 33 patients (29 males and 4 females) and included patients who were clinically diagnosed patients of laryngeal masses, were first evaluated under indirect laryngoscopy and then sent for CT and MRI. Postimaging biopsy was undertaken via direct laryngoscopy. Patients who had contraindications to magnetic resonance (MR) evaluation (pacemakers, claustrophobia, metallic implants) and intravenous administration to contrast material (renal impairment) and patients who were unable to restrain movement and pregnant women were excluded from the study. Results: The sensitivity and specificity in cartilage invasion were as follows: thyroid cartilage (91.7% vs. 71.4%); cricoid cartilage (85.7% vs. 75%); and arytenoid cartilage (91.7% vs. 71.4%). The accuracy rate of MRI in detection of cartilage invasion was thyroid cartilage 84.2%; arytenoid cartilage 84%; cricoid cartilage 78.9%. Diagnostic accuracy of CT staging versus histopathological staging showed sensitivity 60.0%, specificity 85.7%, positive predictive value (PPV) 60.0%, negative predictive value (NPV) 85.7%, accuracy 78.9% (P = 0.084). Diagnostic accuracy of MR staging versus histopathological staging showed sensitivity 80.0%, specificity 92.9%, PPV 80.0%, NPV 92.9%, accuracy 89.5% (P = 0.006). Conclusion: MRI is significantly more sensitive but less specific than CT in detecting neoplastic cartilage invasion. MRI offers higher staging accuracy as compared to CT (89.5% vs. 78.0%) with better soft-tissue resolution and multiplanar imaging.


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