Imaging of laryngeal cancer

Currently CT and MR are the most competitive modalities in the study of laryngeal cancer. Both radiological techniques are used to define the deeper extent of the disease and to look for disease in the blind mucosal areas. They allow evaluation of the exact extent of the tumor and this information is indispensable when one has to decide if a patient is candidate for speech conservation surgery, if a patient can be treated by radiation alone etc. MR is preferred in cooperative patients because it allows multiplanar imaging and provides the best soft tissue definition, both resulting in a more exact staging. Moreover cartilage involvement is best evaluated on MR images. CT is used when the patient has major problems with secretions, is not cooperative, has respiratory problems and when MR is not available. MR and CT are also helpful in the detection of recurrent tumor in postoperative patients but are far less reliable in the distinction between "residual or recurrent tumor" and "fibrosis or edema" in irradiated patients.