Diagnostic accuracy of surface coil MRI in assessing cartilaginous invasion in laryngeal tumours: Do we need contrast-agent administration?

Eur Radiol. 2017 Nov;27(11):4690-4698. doi: 10.1007/s00330-017-4840-x. Epub 2017 May 5.

Abstract

Objectives: To assess the diagnostic accuracy of MRI performed using surface coils, with and without contrast medium, in predicting thyroid and cricoid cartilage infiltration in laryngeal tumours, and to investigate whether the radiologist's experience influences diagnostic accuracy.

Methods: We retrospectively enrolled patients with biopsy-proven laryngeal cancer who had undergone preoperative staging MRI and open surgery. Two radiologists with different experience (senior vs. junior) reviewed the MR images without (session A1) and with contrast medium (session A2) separately. We calculated the accuracy of MRI with and without contrast medium in detecting infiltration of the thyroid and cricoid cartilages. Interobserver agreement was calculated by Cohen's Kappa (k).

Results: Forty-two patients were enrolled, for a total of 62 cartilages. In session A1 the senior and junior radiologists showed an accuracy of 85% and 71%, respectively, with k = 0.53 (0.33-0.72). In session A2 the senior and junior radiologists showed an accuracy of 84% and 77%, respectively, with k = 0.68 (0.49-0.86).

Conclusions: Staging of laryngeal tumours with surface coil MRI showed good diagnostic accuracy in assessing cartilaginous infiltration. We observed similar values of diagnostic accuracy for the analysis performed with and without contrast medium for the senior radiologist.

Key points: • Surface coil MRI demonstrated good accuracy in assessing laryngeal cartilage invasion. • The radiologist's experience can influence the diagnostic accuracy. • Gadolinium administration may increase interobserver concordance.

Keywords: Larynx; Magnetic resonance imaging; Neoplasm; Staging; Surface coil.

MeSH terms

  • Aged
  • Biopsy
  • Clinical Competence
  • Contrast Media
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Laryngeal Cartilages / diagnostic imaging*
  • Laryngeal Cartilages / pathology
  • Laryngeal Neoplasms / diagnostic imaging*
  • Laryngeal Neoplasms / pathology
  • Magnetic Resonance Imaging / methods
  • Male
  • Meglumine / analogs & derivatives*
  • Middle Aged
  • Neoplasm Invasiveness / diagnostic imaging
  • Neoplasm Staging
  • Observer Variation
  • Organometallic Compounds*
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadobenic acid
  • Meglumine