Functional imaging of larynx via 256-Slice Multi-Detector Computed Tomography in patients with laryngeal tumors: a faster, better and more reliable pre-therapeutic evaluation.

OBJECTIVE

To determine the clinical utility of using dynamic maneuvers during imaging of larynx via 256-Slice Multi-Detector Computed Tomography in the pre-therapeutic evaluation of laryngeal tumors.

MATERIALS AND

METHODS

A total of 27 patients (7 women, 20 men; aged 53-76 years) diagnosed with laryngeal squamous cell carcinoma were evaluated pre-therapeutically via contrast enhanced axial CT scans during consecutive phases of phonation (PP), inspiration (IP) and Valsalva maneuver (VP).

RESULTS

In 2 of 5 patients diagnosed with T1a glottic tumor, scans obtained during VP and PP were normal while the CT scans obtained during IP clearly showed a mass. In all patients (27/27) PP provided visualization of the ventricle, on coronal plane images and the pyriform sinus apices, on axial plane images. Involvement of the anterior commissure was best assessable on axial plane IP images (sensitivity 93%, specificity 92%). In cases of stage T1-T3 tumors use of dynamic maneuvers during laryngeal CT imaging showed the location and extension of the tumor better than the single phase CT scans did. We did not find a significant improvement in the pre-therapeutic evaluation in stage T4 tumors.

CONCLUSION

Providing markedly clearer and more detailed evaluation of mucosal surfaces and deep structures of the larynx and mobility of the cords than do conventional scans, use of dynamic laryngeal maneuvers during laryngeal CT imaging seems to be an useful alternative in the pre-therapeutic assessment of laryngeal tumors.