Neoplastic invasion of laryngeal cartilage: reassessment of criteria for diagnosis at MR imaging

PURPOSE: To evaluate whether proposed diagnostic criteria applied to magnetic resonance (MR) images of patients with laryngeal and hypopharyngeal carcinoma may be used to distinguish neoplastic from inflammatory involvement of the laryngeal cartilages. MATERIALS AND METHODS: The radiologic and histopathologic data in 121 consecutive patients with primary squamous cell carcinoma of the larynx (n = 63) or hypopharynx (n = 58) who underwent MR imaging before laryngectomy formed the basis of this retrospective study. Patient consent for retrospective chart review was waived by the institutional review board. All laryngectomy specimens were processed with a dedicated histopathologic whole-organ slice technique. MR images were evaluated by two readers according to established ("old") and proposed ("new") diagnostic criteria on the basis of the signal intensity behavior of cartilage on T2-weighted images and contrast material-enhanced T1-weighted images compared with that of the adjacent tumor. Specifically, with the new criteria, T2-weighted or postcontrast T1-weighted cartilage signal intensity greater than that of the adjacent tumor was considered to indicate inflammation, and signal intensity similar to that of the adjacent tumor was considered to indicate neoplastic invasion. The results of the MR image interpretation were compared with the histologic reference standard. RESULTS: The area under the receiver operating characteristic curve for the new criteria (0.94) was nominally but significantly larger than that for the old criteria (0.92) (P = .01). Overall specificity was significantly improved (82% for new vs 74% for old criteria, P < .001) and was greatest for the thyroid cartilage (75% for new vs 54% for old criteria, P < .001) with the new criteria. The sensitivities of the established and the proposed criteria were identical. CONCLUSION: The proposed MR imaging criteria enable improved differentiation of neoplastic cartilage invasion from peritumoral inflammation

Consensus statement: Long-term results of ABI in children with complex inner ear malformations and decision making between CI and ABI

7th IEEE Asia-Pacific Conference on Applied Electromagnetics, APACE 2016 -- 11 December 2016 through 13 December 2016 -- 127632‘Second Consensus Meeting on Management of Complex Inner Ear Malformations: Long Term Results of ABI in Children and Decision Making Between CI and ABI’ took place on 5–6 April 2013 in Kyrenia, Northern Cyprus with the participation of 20 centers from 11 countries. These centers presented their auditory brainstem implantation (ABI) experience in children and infants and also provided the selection criteria and cochlear implant (CI) results in patients with an abnormal cochlea and nerve. In addition, Cochlear and Med El companies provided presentations regarding solutions to problems during revision surgery and future projections of device technology. According to the results from different centers, it was evident that an ABI is capable of providing hearing sensation in prelingually deafened children with complex inner ear malformations and diseases. It is possible to obtain a pure tone average with an ABI between 30 and 60 dB HL in most of these patients. It has been observed that the majority of children obtain Categories of Auditory Performance (CAP) scores around 5, but occasionally certain ABI users obtained scores of up to CAP 8-II, NEAP-Nottingham Early Assessment Package. The Ear Foundation 2009). CAP scores tend to increase with earlier implantation, i.e. under 2 years of age. However, after 3 years of use, it usually reaches a plateau. Children with additional disorders cannot reach CAP scores of children without disorders. However, they obtain an improvement of cognitive functions but duration of ABI use and increasing chronological age also play a role in this improvement