Role of Magnetic Resonant Imaging in Laryngeal Cancer, NAGHAM N. OMAR, ALAA K. ABD EL-HALEEM, SHERIF M. ABD EL-AL and DINA G.E. MOHAMED
Abstract
Background: MRI plays a significant complementary role to clinical endoscopy in pre therapeutic staging of laryngeal squamous cell carcinoma.
Aim of Study: To evaluate role of MRI in laryngeal cancer, detect its accuracy, specificity in staging, differentiates post irradiation from recurrence.
Patients and Methods: The study was conducted at the Department of Radio Diagnosis, University of Assiut, Egypt. From September 2015 to April 2016, 40 male patients, aged 50-85 years (median 67.5 years), the study comprised patients with suspected or known laryngeal cancer, the symptomatology was predominantly characterized by hoarseness and cough. The study was performed with the approval of all patients give their informed consent to the study.
Results: MRI shows a sensitivity of 100% and a specificity of 97% in assessing areas such as paraglottic space, anterior commissure, thyroid, and arytenoid cartilages with various indications for conservative surgery. The accuracy of MRI In T1 stage was 85% and for laryngoscopy was 85.7%, the accuracy of MRI in T2 stage was 85% and for laryngoscopy was 80%, the accuracy of MRI in T3 stage was 95% and for laryngoscopy was 75%, the accuracy of MRI in T4 stage was 100% and for laryngoscopy was 80%, while for the determi-nation of cartilaginous invasion MR showed a sensitivity 38.9% specificity 100%, accuracy 45%.
Conclusion: Despite some limitations, including the small number of laryngeal carcinomas included, DWI may detect changes in tumor size and shape before they are visible by laryngoscopy. The ADC values were lower for patients with laryngeal carcinoma than for those with laryngeal precancerous lesions. The proposed cutoff for the ADC may help to distin-guish laryngeal carcinomas from laryngeal precancerous lesions.