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DOI: https://doi.org/10.31071/kit2018.14.10


Inventory reference ISSN 1812-7231 Klin.inform.telemed. Volume 13, Issue 14, 2018, Pages 81–101


Author(s) V. N. Sokolov, Z. M. Shavladze, F. D. Evchev, M. V. Pilipuk, V. M. Zvigovskiy, G. M. Pogkovskay, T. K. Dorofeeva, E. M. Doykova, A. A. Corsun, L. V. Anischenco


Institution(s)

Odessa National Medical University, Ukraine


Article title Malignant tumors of the laryngopharynx and larynx — three-dimensional reconstruction and virtual endoscopy


Abstract (resume)

A radiologist makes a valuable contribution to laryngeal cancer diagnostics, thatin fluences planning on treatment. This review focuses on basic anatomical concepts, tumor spreading patterns and methods for detecting these with the use of optimal cross-section processing (SCT, MRT, Wirth Uaon Laryngoscopy, DWI, PET/CT). The work illustrates the issues related to the ratio of tumor to ventricular complex, submucosal laryngeal spaces, involvement of laryngeal cartilage and metastatic spreading. The effect of visualisation results on the spectrum of therapeutic variants is described. Possible advantages of combined methods of SCT, MRI, DWI and PET/CT in the diagnosis of various localisations of laryngeal cancer are demonstrated.

The purpose of the work is to demostrate accurate development of methodical techniques for spiral computed tomography including the use of 3D-reconstruction and virtual endoscopy for suspected malignant tumors of the laryngopharynx and larynx, to establish the stage of the disease progressing by identifying regional and distant metastases, to determine the strategy of radical surgery, to predict the outcome of ongoing treatment and to evaluate the effectiveness of chemotherapy.

Materials and methods. Comparison of possibilities for spiral computed tomography and virtual endoscopy in patients with laryngeal and laryngeal cancer was performed on the basis of an evaluation of the results of the examination in more than 469 patients.
We have studied the effectiveness of various methods of investigation, ranging from standard radiographs to MSCT, MRI, DWI (diffuseweighted imaging) and PET/CT. DWI is based on detection of changes in the nature of Brownian motion of water molecules in various pathological processes, and the values of the diffusion coefficient (DC) were calculated. PET/CT was performed using radiolabeled fluorine 18-deoxyglucose (FDG). This allowed more objective assessment of the possibilities of abovedesignated methods.

Results and conclusions. The use of SCT made possible to determine extensive spread of the process to the adjacent organs (the thyroid gland) and the soft tissues of the neck, to the lumen of the trachea, the destruction of the cartilages of the larynx, and to reveal stenosis. However, the best way to identify stenosis was virtual laryngoscopy. MRI and PET/CT revealed metastasis of the process to regional and distant lymph nodes, identify tumor recurrence, assess the effectiveness of chemoradiotherapy.


Keywords method of using SCT, MRI, virtual endoscopy, DWI, PET/CT, metabolism of radiolabeled glucose, cancer of the larynx and laryngeal-pharynx


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