Staging of laryngeal cancer: Endoscopy, computed tomography and magnetic resonance versus histopathology

Autor: Hubert Läng, Minerva Becker, P Zbären
Rok vydání: 1997
Předmět:
Gadolinium DTPA
Male
Larynx
Laryngeal Cartilages
Laryngeal Cartilages/pathology
Contrast Media
Gadolinium
Patient Care Planning
Clinical Protocols
Medicine
Prospective Studies
610 Medicine & health
Aged
80 and over
medicine.diagnostic_test
Larynx/pathology
Soft tissue
General Medicine
Middle Aged
Pentetic Acid
Laryngeal Neoplasm
Magnetic Resonance Imaging
Radiographic Image Enhancement
medicine.anatomical_structure
Female
Neurosurgery
Radiology
Adult
medicine.medical_specialty
Decision Making
ddc:616.0757
Organometallic Compounds
Humans
Neoplasm Invasiveness
Organometallic Compounds/diagnostic use
Laryngeal Neoplasms
Aged
Neoplasm Staging
Neck/pathology
Laryngoscopy
business.industry
Cancer
Magnetic resonance imaging
Image Enhancement
medicine.disease
Endoscopy
Gadolinium/diagnostic use
Laryngeal Neoplasms/pathology/surgery
Otorhinolaryngology
Histopathology
Tomography
X-Ray Computed
business
Neck
Pentetic Acid/analogs & derivatives/diagnostic use
Zdroj: Zbären, Peter; Becker, M.; Läng, H. (1997). Staging of laryngeal cancer: Endoscopy, computed tomography and magnetic resonance versus histopathology. European archives of oto-rhino-laryngology, 254(S1), S117-S122. Springer 10.1007/BF02439740
European Archives of Oto-Rhino-Laryngology, Vol. 254 Suppl 1 (1997) pp. S117-22
ISSN: 1434-4726
0937-4477
DOI: 10.1007/bf02439740
Popis: An accurate pretherapeutic staging of laryngeal cancer is required for optimal treatment planning and for evaluation and comparison of the results of different treatment modalities. In this study, 45 consecutive patients with neoplasms of the larynx, treated surgically, were included in a prospective pretherapeutic staging protocol that included indirect laryngoscopy, direct microlaryngoscopy, contrast-enhanced computed tomography (CT) and Gd-DTPA-enhanced magnetic resonance imaging (MRI). The surgical specimens were cut in whole-organ slices parallel to the plane of the axial CT and MR images. The histologic findings were then compared with clinical findings, CT and MRI. These findings showed that clinical evaluation failed to identify tumor invasion of the laryngeal cartilages and extralaryngeal soft tissues, resulting in a low staging accuracy (55%). Many pT4 tumors were clinically understaged. The combination of clinical/endoscopic evaluation and either CT or MRI resulted in a significantly improved staging accuracy (80% vs 87%, respectively). MRI was significantly more sensitive but less specific than CT in detecting neoplastic cartilage invasion. MRI tended to overestimate neoplastic cartilage invasion to possibly result in overtreatment, while CT was found to underestimate neoplastic cartilage invasion and could lead to inadequate therapeutic decisions.
Databáze: OpenAIRE
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