Patterns of framework invasion in patients with laryngeal cancer - Correlation of in vitro magnetic resonance imaging and pathological findings

Total laryngectomy for laryngeal squamous cell carcinoma means a drastic ch ange in the way of living For a patient. New surgical techniques such as la ser surgery attempt to save the voice. To be oncologically correct, an accu rate assessment of the tumor extent is necessary. imaging is especially imp ortant in determining tumor extent in the regions where conventional and en doscopic ENT examinations are less accurate. Correlations of CT, in vivo MR I and pathological findings after surgery have demonstrated that MRI is mor e sensitive than CT, but that it overestimates the degree of cartilage inva sion. Cartilage invasion is believed to be a contraindication to radiation therapy and voice-sparing surgery. In a prospective study, Gd-enhanced bl v itro MRI of 10 total laryngectomy specimens was correlated with subsequent pathological examination. Good correlation of the anatomical relationships of the tumor between the in vitro images and gross pathology were found. Im portant is the absence of false negatives in our study, indicating that car tilage invasion can be ruled out when a normal signal intensity on in vitro MRI of the cartilage is seen. This has important oncological implications for partial voice-sparing laryngeal surgery.