Laryngeal carcinoma: high-resolution computed tomography and thick anatomic sections

Area of Science:

• Radiology
• Oncology
• Otolaryngology

Background:

• Accurate staging of laryngeal carcinoma is crucial for effective treatment planning.
• Computed tomography (CT) is a key imaging modality for assessing head and neck tumors.
• Early detection and precise determination of tumor extent, especially cartilage invasion, remain challenging.

Purpose of the Study:

• To evaluate the diagnostic value of high-resolution CT in the early detection of primary laryngeal carcinoma.
• To assess CT's reliability in establishing the true tumor extent, with a focus on early cartilage invasion.

Main Methods:

• Review of high-resolution (2-mm thick) sequential CT scans from 23 patients with primary laryngeal carcinoma.
• Correlation of CT findings with surgical resection specimen results to determine accuracy.
• Analysis of false-negative and false-positive findings in relation to lesion characteristics and benign mimics.

Main Results:

• CT demonstrated high accuracy in detecting tumor extent for visible tumors, with no false negatives in such cases.
• Early cartilage invasion was reliably detected by CT, characterized by a fenestrated chondral margin.
• False negatives occurred with superficial lesions on the true vocal cord mucosa; false positives were associated with vocal cord polyps and granulomatous reactions.

Conclusions:

• High-resolution CT is valuable for assessing the extent of primary laryngeal carcinoma, particularly for detecting cartilage invasion.
• Benign conditions like vocal cord polyps or granulomas can mimic malignancy on CT, necessitating careful interpretation.
• CT findings, such as fenestrated chondral margins, correlate well with surgical findings of cartilage involvement.