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Purpose <p>There is no uniformity across various guidelines in defining the modality and frequency of the follow-up, particularly regarding radiological imaging. The objective is to assess the diagnostic performance of magnetic resonance imaging (MRI)-based posttreatment surveillance for early-stage (I–II) glottic squamous cell carcinoma of the larynx.</p> Methods <p>The follow-up of patients diagnosed with glottic squamous cell carcinoma of the larynx, treated with radiotherapy or surgery in curative intent, was analyzed over a&#xa0;period of 2&#xa0;years posttreatment. MRI diagnostic performance metrics were calculated using clinical and post-MRI endoscopic examinations as the reference standard. MRI sequences included both anatomical and functional imaging, including diffusion-weighted imaging.</p> Results <p>In total, 171 eligible MRIs were analyzed in the follow-up. Recurrences were identified with a&#xa0;sensitivity of 75% and a&#xa0;specificity of 99%. However, the positive predictive value of MRI surveillance reflects considerable uncertainty in the diagnosis of recurrences based solely on MRI findings, dropping as low as 21% in sensitivity analyses. Moreover, a&#xa0;notable proportion of MRIs were inconclusive.</p> Conclusion <p>MRI demonstrates high specificity and acceptable sensitivity; however, the limited positive predictive value raises concerns regarding its utility as a&#xa0;stand-alone surveillance tool.</p>

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Diagnostic value of MRI for posttreatment surveillance of early-stage (I–II) glottic larynx cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月2日

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  • Lucas Mose,
  • Emre Korkmaz,
  • Miranda Visini,
  • Roland Giger,
  • Daniel Hendrik Schanne,
  • Olgun Elicin

摘要

Purpose

There is no uniformity across various guidelines in defining the modality and frequency of the follow-up, particularly regarding radiological imaging. The objective is to assess the diagnostic performance of magnetic resonance imaging (MRI)-based posttreatment surveillance for early-stage (I–II) glottic squamous cell carcinoma of the larynx.

Methods

The follow-up of patients diagnosed with glottic squamous cell carcinoma of the larynx, treated with radiotherapy or surgery in curative intent, was analyzed over a period of 2 years posttreatment. MRI diagnostic performance metrics were calculated using clinical and post-MRI endoscopic examinations as the reference standard. MRI sequences included both anatomical and functional imaging, including diffusion-weighted imaging.

Results

In total, 171 eligible MRIs were analyzed in the follow-up. Recurrences were identified with a sensitivity of 75% and a specificity of 99%. However, the positive predictive value of MRI surveillance reflects considerable uncertainty in the diagnosis of recurrences based solely on MRI findings, dropping as low as 21% in sensitivity analyses. Moreover, a notable proportion of MRIs were inconclusive.

Conclusion

MRI demonstrates high specificity and acceptable sensitivity; however, the limited positive predictive value raises concerns regarding its utility as a stand-alone surveillance tool.