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Galli et al. J Cancer Metastasis Treat 2022;8:48 Journal of Cancer
DOI: 10.20517/2394-4722.2022.19
Metastasis and Treatment

Original Article Open Access

Diagnostic accuracy of MRI and PET/CT for neck
staging prior to salvage total laryngectomy

Jonas Galli 1,# , Roland Giger 1,# , Olgun Elicin 2 , Martin Wartenberg 3 , Lukas Anschuetz 1 , Lluís
Nisa 1
1
Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, and University of Bern, Bern
3010, Switzerland.
2
Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern 3010, Switzerland.
3
Institute of Pathology, University of Bern, Bern 3008, Switzerland.
#
Authors contributed equally.
Correspondence to: Jonas Galli, Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Freiburgstrasse 18,
Bern 3010, Switzerland. E-mail: jonas.galli@insel.ch
How to cite this article: Galli J, Giger R, Elicin O, Wartenberg M, Anschuetz L, Nisa L. Diagnostic accuracy of MRI and PET/CT
for neck staging prior to salvage total laryngectomy. J Cancer Metastasis Treat 2022;8:48. https://dx.doi.org/10.20517/2394-
4722.2022.19

Received: 18 Feb 2022 First Decision: 26 Jul 2022 Revised: 24 Aug 2022 Accepted: 8 Dec 2022 Published: 23 Dec 2022

Academic Editors: Fausto Chiesa, Rafat A. Siddiqui Copy Editor: Ke-Cui Yang Production Editor: Ke-Cui Yang

Abstract
Aim: Lymph node (LN) metastases are associated with poor outcomes in patients with recurrent larynx squamous
cell carcinoma (LSCC). Neck dissection (ND) is therefore commonly performed along with salvage total
laryngectomy (STL). Here, we assess the rate of occult LN metastases and the diagnostic value of MRI and PET/CT
for detecting them in recurrent LSCC.

Methods: This retrospective study included patients with recurrent LSCC after primary (chemo)radiotherapy
[(C)RT] who were re-staged by MRI and/or PET/CT and treated with STL and ND between 2004 and 2019. The
histopathology of ND samples was used as the reference standard.

Results: Forty-one patients were included. The prevalence of occult metastases in MRI-negative and
PET/CT-negative neck nodes was between 3.2% and 6.1%. Negative predictive values of neck node re-staging
were 93.9% for MRI, 96.8% for PET/CT, and 96.2% for MRI and PET/CT combined.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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