Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-23T18:14:47.955Z Has data issue: false hasContentIssue false
  • English
  • Français

Accuracy of magnetic resonance imaging in diagnosing thyroid cartilage and thyroid gland invasion by squamous cell carcinoma in laryngectomy patients

Published online by Cambridge University Press:  11 January 2012

A J Kinshuck ,
P W A Goodyear ,
J Lancaster ,
N J Roland ,
S Jackson ,
R Hanlon ,
H Lewis-Jones ,
J Sheard  and
T M Jones
A J Kinshuck*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
P W A Goodyear
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
J Lancaster
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
N J Roland
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
S Jackson
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
R Hanlon
Affiliation:
Department of Radiology, University Hospital Aintree, Liverpool, UK
H Lewis-Jones
Affiliation:
Department of Radiology, University Hospital Aintree, Liverpool, UK
J Sheard
Affiliation:
Department of Pathology, University Hospital Aintree, Liverpool, UK
T M Jones
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Liverpool, UK Liverpool CR-UK Centre, School of Cancer Studies, University of Liverpool, UK
*
Address for correspondence: Mr A J Kinshuck, Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK E-mail: akinshuck@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

We examined the accuracy of magnetic resonance imaging in assessing thyroid cartilage and thyroid gland invasion in patients undergoing total laryngectomy for squamous cell carcinoma, by comparing histopathology results with imaging findings.

Study design:

A retrospective study reviewed histology and magnetic resonance scan results for all total laryngectomies performed between 1998–2008 at University Hospital Aintree, Liverpool.

Methods:

Pre-operative magnetic resonance images were reviewed independently by two consultant head and neck radiologists masked to the histology; their opinions were then compared with histology findings.

Results:

Eighty-one magnetic resonance scans were reviewed. There were 22 laryngectomy patients with histologically verified thyroid cartilage invasion and one patient with thyroid gland invasion. There were 31 patients with apparent radiological thyroid cartilage invasion pre-operatively (with 17 false positives), giving sensitivity, specificity, and positive and negative predictive values of 64, 71, 45 and 84 per cent, respectively. On assessing thyroid gland invasion, there were nine false positive scans and no false negative scans, giving sensitivity, specificity, and positive and negative predictive values of 100, 89, 10 and 100 per cent, respectively.

Conclusion:

Magnetic resonance scanning over-predicts thyroid cartilage and gland invasion in patients undergoing total laryngectomy. Magnetic resonance scans have limited effectiveness in predicting thyroid cartilage invasion by squamous cell carcinoma in laryngectomy patients.

Keywords

Total LaryngectomyMRI scansThyroid CartilageThyroid Gland
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 3 , March 2012 , pp. 302 - 306
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Becker, M, Burkhardt, K, Dulguerov, P, Allal, A. Imaging of the larynx and hypopharynx. Eur J Radiol 2008;66:460–79CrossRefGoogle ScholarPubMed
2Edge, SB, Compton, CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010;17:1471–4CrossRefGoogle ScholarPubMed
3Castelijns, JA, Becker, M, Hermans, R. Impact of cartilage invasion on treatment and prognosis of laryngeal cancer. Eur Radiol 1996;6:156–69CrossRefGoogle ScholarPubMed
4Mendelson, AA, Al-Khatib, TA, Julien, M, Payne, RJ, Black, MJ, Hier, MP. Thyroid gland management in total laryngectomy: meta-analysis and surgical recommendations. Otolaryngol Head Neck Surg 2009;140:298–305CrossRefGoogle ScholarPubMed
5Gilbert, RW, Cullen, RJ, van Nostrand, AW, Bryce, DP, Harwood, AR. Prognostic significance of thyroid gland involvement in laryngeal carcinoma. Arch Otolaryngol Head Neck Surg 1986;112:856–9CrossRefGoogle ScholarPubMed
6Fagan, JJ, Kaye, PV. Management of the thyroid gland with laryngectomy for cT3 glottic carcinomas. Clin Otolaryngol Allied Sci 1997;22:7–12CrossRefGoogle ScholarPubMed
7Zbaren, P, Becker, M, Lang, H. Staging of laryngeal cancer: endoscopy, computed tomography and magnetic resonance versus histopathology. Eur Arch Otorhinolaryngol 1997;254(suppl 1): S117–22CrossRefGoogle ScholarPubMed
8Castelijns, JA, Gerritsen, GJ, Kaiser, MC, Valk, J, van Zanten, TE, Golding, RG et al. Invasion of laryngeal cartilage by cancer: comparison of CT and MR imaging. Radiology 1988;167:199–206CrossRefGoogle ScholarPubMed
9Atula, T, Markkola, A, Leivo, I, Makitie, A. Cartilage invasion of laryngeal cancer detected by magnetic resonance imaging. Eur Arch Otorhinolaryngol 2001;258:272–5CrossRefGoogle ScholarPubMed
10Becker, M. Neoplastic invasion of laryngeal cartilage: radiologic diagnosis and therapeutic implications. Eur J Radiol 2000;33:216–29CrossRefGoogle ScholarPubMed
11Becker, M, Zbaren, P, Casselman, JW, Kohler, R, Dulguerov, P, Becker, CD. Neoplastic invasion of laryngeal cartilage: reassessment of criteria for diagnosis at MR imaging. Radiology 2008;249:551–9CrossRefGoogle ScholarPubMed
12Kazkayasi, M, Onder, T, Ozkaptan, Y, Can, C, Pabuscu, Y. Comparison of preoperative computed tomographic findings with postoperative histopathological findings in laryngeal cancers. Eur Arch Otorhinolaryngol 1995;252:325–31CrossRefGoogle ScholarPubMed
13Zbaren, P, Becker, M, Lang, H. Pretherapeutic staging of laryngeal carcinoma. Clinical findings, computed tomography, and magnetic resonance imaging compared with histopathology. Cancer 1996;77:1263–733.0.CO;2-J>CrossRefGoogle ScholarPubMed
14Becker, M, Zbaren, P, Laeng, H, Stoupis, C, Porcellini, B, Vock, P. Neoplastic invasion of the laryngeal cartilage: comparison of MR imaging and CT with histopathologic correlation. Radiology 1995;194:661–9CrossRefGoogle ScholarPubMed
15Brennan, JA, Meyers, AD, Jafek, BW. The intraoperative management of the thyroid gland during laryngectomy. Laryngoscope 1991;101:929–34CrossRefGoogle ScholarPubMed
16Lam, KH. Extralaryngeal spread of cancer of the larynx: a study with whole-organ sections. Head Neck Surg 1983;5:410–12CrossRefGoogle ScholarPubMed