Detecting an infiltration of laryngeal cartilage in case of hypopharyngeal and laryngeal carcinomas: How accurate are the preoperative radiological findings of CT-Imaging and MRI?

Introduction In cases of hypopharynx or larynx carcinoma an infiltration of the laryngeal cartilage is decisive for therapy. Therefore preoperative imaging is necessary and indicated, as stated in S3-guideline for larynx carcinoma. We wanted to find out how accurate the findings of laryngeal infiltration in preop. imaging are in relation to histological results.

Material & Methods Researching all patients who had a laryngectomie in the years 2016 to 2021, histological evaluation of infiltration of the laryngeal cartilage and comparison of these results with the findings of preoperative imagings (divided in false positive, false negative and correct diagnoses) while taking into account the different methods of imaging.

Results In the afore mentioned period 91 patients had a laryngectomie. A histological confirmation of infiltration of the laryngeal cartilage was found in 60 cases. Preoperative imaging consisted in 82 cases of a CT and in 22 cases of a MRI (13 patients got a CT and MRI). The highest sensitivity (77%) in regard to laryngeal cartilage infiltration was seen in CT (MRI: 55%, CT+MRI: 54%). Inconsistent results were most often seen in CT-/ MRI-imaging that described infiltration of the cartilage which could not be proven in the respective histologies (63% of all incorrect findings).

Discussion Planning the treatment of hypopharyngeal/ laryngeal carcinomas requires an adequate imaging. CT-imaging seems to be more sensitive than an MRI in regard to a detection of laryngeal cartilage infiltration. A combination of both methods of imaging did not provide an advantage (in an admittedly small collective of patients). A preoperative CT-Imaging is to be recommended if there is an infiltration of laryngeal cartilage suspected.

Publication History

Article published online:
24 May 2022