KBB-Forum 2023 , Cilt 22, Sayı 2

COMPARISON OF COMPUTED TOMOGRAPHY, MAGNETİC RESONANCE IMAGING AND POSITRON EMISSION TOMOGRAPHY IN DETECTING CARTILAGE INVASION IN LARYNX CANCERS

Mehmet BİRİNCİ 1, MD; Fatma BEYAZAL ÇELİKER 2, MD; Özlem ÇELEBİ ERDİVANLI 1, MD; Tuğba YEMİŞ 1, MD; Osman KUPİK 3, MD; Suat TERZİ 4, MD; Metin ÇELİKER 1, MD; Recep BEDİR 5, MD; Zerrin ÖZERGİN COŞKUN 1, MD; Emine DEMİR 6, MD; Engin DURSUN 7, MD;
1Recep Tayyip Erdogan University Faculty of Medicine, Otorhinolaryngology, Rize, Turkey
2Recep Tayyip Erdogan University Faculty of Medicine, Radiology, Rize, Turkey
3Muğla Sıtkı Koçman University Faculty of Medicine, Nuclear Medicine, Mugla, Turkey
4Imperial Hospital, Otorhinolaryngology, Trabzon, Turkey
5Recep Tayyip Erdogan University Faculty of Medicine, Pathology, Rize, Turkey
6Altunbaş University Faculty of Medicine, Otorhinolaryngology, Istanbul, Turkey
7Lokman Hekim University Faculty of Medicine, Otorhinolaryngology, Ankara, Turkey Objective: Laryngeal cancer is the most common malignancy of the head and neck region, following skin tumors. Cartilage invasion is an important feature in staging of laryngeal cancers. This study compared three frequently used radiologic tests used to detect cartilage invasion in laryngeal cancers.

Materials and Methods: Medical records of 33 patients, who underwent total laryngectomy between 2014 and 2018, were retrospectively reviewed. Data from 11 patients, who had undergone both PET/CT, CT, and MRI were analyzed. The radiologic test results were re-evaluated for cartilage invasion by one radiologist and one nuclear medicine specialist experienced in head and neck cancers, who were blinded to any other patient data. The scores given by the examiners were compared with the pathology specimen results to form a confusion matrix.

Results: All except 1 patient were male (91%). The mean age was 64 years (51-80). All except 1 patient had a history of smoking. TNM staging was T4a in 6 patients, T2 in 4 patients, and T3 in 1 patient. Two patients received salvage surgery after radiotherapy. Most frequent tumor localization was transglottic. PET/CT, CT, and MRI methods were all 83.3% sensitive, specificity was 80%, 60%, 40%; positive predictive value was 83.3%, 75%, 62.5%; negative predictive value was 72.7%, 66%, 80%, and the accuracy was 81.8%, 72.7%, 63.6%, respectively.

Conclusions: Despite similar sensitivity, PET/CT examination scored best in specificity, positive and negative predictive value, whereas MRI scored worst. Keywords : Larynx carcinoma, computed tomography, magnetic resonance imaging, positron emission tomography