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Accuracy of magnetic resonance imaging in diagnosing thyroid cartilage and thyroid gland invasion by squamous cell carcinoma in laryngectomy patients

  • A J Kinshuck (a1), P W A Goodyear (a1), J Lancaster (a1), N J Roland (a1), S Jackson (a1), R Hanlon (a2), H Lewis-Jones (a2), J Sheard (a3) and T M Jones (a1) (a4)...

We examined the accuracy of magnetic resonance imaging in assessing thyroid cartilage and thyroid gland invasion in patients undergoing total laryngectomy for squamous cell carcinoma, by comparing histopathology results with imaging findings.

Study design:

A retrospective study reviewed histology and magnetic resonance scan results for all total laryngectomies performed between 1998–2008 at University Hospital Aintree, Liverpool.


Pre-operative magnetic resonance images were reviewed independently by two consultant head and neck radiologists masked to the histology; their opinions were then compared with histology findings.


Eighty-one magnetic resonance scans were reviewed. There were 22 laryngectomy patients with histologically verified thyroid cartilage invasion and one patient with thyroid gland invasion. There were 31 patients with apparent radiological thyroid cartilage invasion pre-operatively (with 17 false positives), giving sensitivity, specificity, and positive and negative predictive values of 64, 71, 45 and 84 per cent, respectively. On assessing thyroid gland invasion, there were nine false positive scans and no false negative scans, giving sensitivity, specificity, and positive and negative predictive values of 100, 89, 10 and 100 per cent, respectively.


Magnetic resonance scanning over-predicts thyroid cartilage and gland invasion in patients undergoing total laryngectomy. Magnetic resonance scans have limited effectiveness in predicting thyroid cartilage invasion by squamous cell carcinoma in laryngectomy patients.

Corresponding author
Address for correspondence: Mr A J Kinshuck, Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK E-mail:
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1Becker, M, Burkhardt, K, Dulguerov, P, Allal, A. Imaging of the larynx and hypopharynx. Eur J Radiol 2008;66:460–79
2Edge, SB, Compton, CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010;17:1471–4
3Castelijns, JA, Becker, M, Hermans, R. Impact of cartilage invasion on treatment and prognosis of laryngeal cancer. Eur Radiol 1996;6:156–69
4Mendelson, AA, Al-Khatib, TA, Julien, M, Payne, RJ, Black, MJ, Hier, MP. Thyroid gland management in total laryngectomy: meta-analysis and surgical recommendations. Otolaryngol Head Neck Surg 2009;140:298305
5Gilbert, RW, Cullen, RJ, van Nostrand, AW, Bryce, DP, Harwood, AR. Prognostic significance of thyroid gland involvement in laryngeal carcinoma. Arch Otolaryngol Head Neck Surg 1986;112:856–9
6Fagan, JJ, Kaye, PV. Management of the thyroid gland with laryngectomy for cT3 glottic carcinomas. Clin Otolaryngol Allied Sci 1997;22:712
7Zbaren, P, Becker, M, Lang, H. Staging of laryngeal cancer: endoscopy, computed tomography and magnetic resonance versus histopathology. Eur Arch Otorhinolaryngol 1997;254(suppl 1): S117–22
8Castelijns, JA, Gerritsen, GJ, Kaiser, MC, Valk, J, van Zanten, TE, Golding, RG et al. Invasion of laryngeal cartilage by cancer: comparison of CT and MR imaging. Radiology 1988;167:199206
9Atula, T, Markkola, A, Leivo, I, Makitie, A. Cartilage invasion of laryngeal cancer detected by magnetic resonance imaging. Eur Arch Otorhinolaryngol 2001;258:272–5
10Becker, M. Neoplastic invasion of laryngeal cartilage: radiologic diagnosis and therapeutic implications. Eur J Radiol 2000;33:216–29
11Becker, M, Zbaren, P, Casselman, JW, Kohler, R, Dulguerov, P, Becker, CD. Neoplastic invasion of laryngeal cartilage: reassessment of criteria for diagnosis at MR imaging. Radiology 2008;249:551–9
12Kazkayasi, M, Onder, T, Ozkaptan, Y, Can, C, Pabuscu, Y. Comparison of preoperative computed tomographic findings with postoperative histopathological findings in laryngeal cancers. Eur Arch Otorhinolaryngol 1995;252:325–31
13Zbaren, P, Becker, M, Lang, H. Pretherapeutic staging of laryngeal carcinoma. Clinical findings, computed tomography, and magnetic resonance imaging compared with histopathology. Cancer 1996;77:1263–73
14Becker, M, Zbaren, P, Laeng, H, Stoupis, C, Porcellini, B, Vock, P. Neoplastic invasion of the laryngeal cartilage: comparison of MR imaging and CT with histopathologic correlation. Radiology 1995;194:661–9
15Brennan, JA, Meyers, AD, Jafek, BW. The intraoperative management of the thyroid gland during laryngectomy. Laryngoscope 1991;101:929–34
16Lam, KH. Extralaryngeal spread of cancer of the larynx: a study with whole-organ sections. Head Neck Surg 1983;5:410–12
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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