Pretherapeutic staging of laryngeal carcinoma: Clinical findings, computed tomography, and magnetic resonance imaging compared with histopathology

Abstract

Clinical/endoscopic examination alone failed to identify tumor invasion of the laryngeal cartilages and of the extralaryngeal soft tissues, resulting in a low staging accuracy (57.5%). Many pT4 (according to the International Union against Cancer TNM Staging System) tumors were clinically unrecognized. The combination of clinical/endoscopic evaluation and an additional radiologic examination, either CT or MR imaging, resulted in significantly improved staging accuracy (80% vs. 87.5%). MR imaging is significantly more sensitive but less specific than CT in detecting neoplastic cartilage invasion. Therefore, MR imaging tends to overestimate neoplastic cartilage invasion and may result in overtreatment, whereas CT tends to underestimate neoplastic cartilage invasion and may lead to inadequate therapy.