title: Contrast-agent enhancement in ex vivo flat-panel computed tomography of locally advanced laryngeal cancer.
abstract: CONCLUSIONS
  Visualization of cartilage invasion in ex vivo laryngectomy specimens was improved by flat-panel volumetric computed tomography (fpvCT) after diffusion of contrast agents. A prospective study to assess the specificity and sensitivity of this new method is warranted.
  
  
  OBJECTIVE
  Cartilage invasion is a criterion for staging laryngeal squamous cell carcinoma. Contrast-enhanced CT is routinely used for assessing cartilage invasion. However, the sensitivities and specificities given for this method in the literature vary, and there is a need for improvement of this staging method. The objective of our pilot study was to determine cartilage invasion with fpvCT after contrast agent diffusion.
  
  
  METHODS
  Three patients underwent preoperative CT and total laryngectomy. The excised larynges were immediately scanned with an fpvCT scanner, without contrast enhancement. Additional fpvCT scans were performed after incubation of the larynges in one of three different contrast agents for 24 and 48 h. The results from presurgical conventional scans, fpvCT scans, and histological examination - as the gold standard - were compared.
  
  
  RESULTS
  We demonstrated the feasibility of ex vivo contrast enhancement of laryngeal tissues by diffusion, with a subsequent increase in contrast enhancement and improved visualization of cartilage invasion in fpvCT scans. Histology confirmed the fpvCT results.
authors.affiliation: Department of Otorhinolaryngology.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kroll
authors.forename: Shachi Jenny
authors.initials: SJ
authors.lastname: Sharma
authors.forename: Thomas
authors.initials: T
authors.lastname: Dreyer
authors.forename: Astrid
authors.initials: A
authors.lastname: Grams
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Klussmann
authors.forename: Martin
authors.initials: M
authors.lastname: Obert
authors.forename: Claus
authors.initials: C
authors.lastname: Wittekindt
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007817:Laryngeal Cartilages / Q000000981:diagnostic imaging* / Q000473:pathology; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media