Louai Sohil Al-Qatawna*, Ola Abdelrahim Attieh, Ala'a Ahmad Al-Zub'i, Dogan Ahmad Atiyat, Bashar Abdel Wahab Shamayleh


Background: The leading factors associated with mortality in laryngeal malignancy are the recurrence of pathology and spread of the disease. Anatomical and histological changes induced by surgery with or without complementary radiation therapy for the initial laryngeal malignancy may make it more difficult to confirm recurrence or remnant pathology. Increased precision in the confirmation of recurrence in head and neck malignancy can be achieved using various therapeutic methods, such as fluorodeoxyglucose-positron emission tomography-computed tomography. Goal: To assess the confirmation precision of fluorodeoxyglucose-positron emission tomography-computed tomography in cases of possible postoperative recurrence of laryngeal malignancy treated with or without complementary radiotherapy. Methods: Our retrospective investigation included 104 participants, who were assigned to various operative procedures with or without complementary radiotherapy for the initial laryngeal malignancy. Confirmation of possible recurrence was undertaken using fluorodeoxyglucose-positron emission tomography-computed tomography after clinical computed tomography and magnetic resonance imaging between January 2010 and January 2020, at the nuclear medicine department, King Hussein medical center, Jordanian Royal medical services, Amman, Jordan. The inclusion criteria assumed that subjects were assigned to fluorodeoxyglucose-positron emission tomography-computed tomography imaging because of inability to determine recurrence using clinical and computed tomography or magnetic resonance imaging. The disease stage was clinically evaluated in terms of the 7th TNM staging (AJCC). Positron subjects were intravenously administered 18F-FDG (37 MBq/10 kg body weight) (EANM) (8). The investigation extended from the skull to the middle of the thigh [scan at 10 mA, CT scan (120 kVp, 50–120 mA) and a 3D whole-body PET scan (2 min) (OSEM)]. Emission tomography-computed tomography was classified as true positive and true negative, and sensitivity and specificity were determined. Results: Fifty-nine subjects were included and 45 subjects were excluded. In 32 subjects (54.2%), there was a possible recurrence of T (15 of SCL, 5 of SGL and 12 of TL) and in 27 subjects (45.8%), there was a possible N. In 15 out of 32 subjects, PET/CT was positive. In the other 17 subjects, PET/CT and biopsy were negative with no recurrence at the initial location. Specificity and sensitivity of positron emission tomography-computed tomography were 86.8% and 98.8%, respectively. Regarding the possible recurrence in the initial location; sensitivity and specificity of positron emission tomography-computed tomography were 98.8% and 86.3%, respectively. In possible spread of neck pathology, positron emission tomography-computed tomography had a sensitivity and specificity of 98.8% and 88.8%. Conclusion: Positron emission tomography-computed tomography in laryngeal cancer is helpful in cases of possible recurrence where traditional computed tomography or magnetic resonance cannot confirm the diagnosis.

Keywords: Laryngeal: Malignancy, Recurrence, PET/CT; Sensitivity, Specificity.

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