Laryngeal Cancer: How does The Radiologist Help – GetWellGo

Learn how a radiologist plays a vital role in diagnosing and guiding treatment for laryngeal cancer with expert support from GetWellGo’s medical team.

Laryngeal Cancer: How does The Radiologist Help – GetWellGo

  • Category

    General

  • Published By

    GetWellGo Team

  • Updated on

    29-Apr-2025

What is Laryngeal Cancer?

Laryngeal cancer is a type of cancer that affects the larynx or the human voice box that exists in the throat. It is involved in phonation, as well as in respiration or swallowing processes. Laryngeal cancer is the cancer that starts from the squamous cell carcinoma that is located in the lining of the larynx.

Laryngeal Cancer Radiology

Radiology is another important aspect when it comes to laryngeal cancer diagnosis and staging, as well as planning of the right treatment. Major imaging examinations that are used in the diagnosis of laryngeal cancer are CT scans, MRI, and PET scan.

Laryngeal Cancer MRI

MRI is especially beneficial for the evaluation of soft tissues; it may give better visions of the larynx and the adjacent structures than CT. It is also used in the assessment of the following:

  • Invasion of nearby tissues, such as the muscles, skin, or cartilage
  • A nerve palsy especially the recurrent laryngeal nerve responsible for controlling cords of voice
  • Lymph node metastasis in the neck
  • Tumor staging and pre-surgical planning

MRI provides better contrast of soft tissues than the CT and it can determine the location of the tumor in close proximity to crucial structures.

CT Scan Laryngeal Cancer

CT scans give good images of the larynx, throat, and other related areas and aid in determining degree of tumor infiltration of the affected tissues. The CT scan can reveal:

  • Tumor size and location within the larynx
  • It is important for staging and management of the tumor because lymph node involvement in the neck region is highly correlated with the invasiveness of the tumor.
  • It is also important in case the cancer broke the barrier of the bone basement affects the base of skull or the cervical vertebrae.
  • Invasion of surrounding structures, such as the pharynx, trachea, or esophagus

Contrast-enhanced CT scans are then more useful to define the tumor and especially the anatomy of the surroundings.

Best Imaging for Laryngeal Cancer

The choice of the imaging technique in laryngeal cancer is dependent with the question asked and the stage or area of the cancer. However, several imaging methods may be employed to provide detailed information on the type of tumor, its size and the relation with the surrounding tissues. The following are the useful imaging modalities that are useful in the management of laryngeal cancer and the benefits of each:

  • MRI (Magnetic Resonance Imaging)
  • CT (Computed Tomography)
  • PET-CT (Positron Emission Tomography-Computed Tomography)
  • Endoscopy (Direct Laryngoscopy) with Biopsy
  • Ultrasound
  • X-ray

Laryngeal Cancer Diagnosis CT

Key Aspects of CT Imaging in the Diagnosis of Laryngeal Cancer:

  • Tumor Detection and Localization
  • Assessment of Lymph Node Involvement
  • Assessment of Bony Invasion
  • Preoperative and Surgical Planning
  • Assessment of Distant Metastasis
  • Detection of Complications

Radiology of Laryngeal Tumors

Under the radiology of laryngeal tumors includes methods that aid in the diagnosis, determining the type of tumors, planning a treatment process as well as monitoring the progress of the tumor within the larynx.

Radiology is important because the larynx is a three-dimensional structure and the tumor’s scope cannot be evaluated during endoscopy.

Laryngeal Cancer Early Detection Imaging

Check localized tumors before they become malignant; extend their probes to other tissues or part of the body.
This increases an opportunity of voice preservation, decreased invasive procedures and better survival rates.

MRI

  • Best for early tumors involving soft tissue and mucosa

CT

  • Good for early submucosal spread and minor cartilage involvement

High-Resolution Endoscopy (Video Laryngoscopy)

  • First-line for mucosal visualization

PET-CT

  • Rarely used for early tumors unless staging advanced

MRI vs CT for Laryngeal Cancer

Feature

MRI

CT

Soft Tissue Contrast

Excellent (best for early tumor detection, soft tissue detail)

Good, but less than MRI

Cartilage Invasion Detection

Very good (especially early cartilage infiltration)

Very good for advanced cartilage destruction (erosion, sclerosis)

Bone Involvement

Less sensitive than CT for bony structures

Best for assessing bone erosion and thyroid cartilage ossification

Lymph Node Evaluation

Good (can show node size and necrosis)

Very good (better for detecting calcified nodes)

Speed

Slower (30–45 min scan)

Faster (5–10 min scan)

Availability & Cost

More expensive, less available

Widely available, less costly

Artifacts

Motion sensitive (swallowing can blur images)

Less sensitive to motion artifacts

Use in Post-treatment Follow-up

Superior for differentiating recurrence vs post-radiation fibrosis

Less specific for fibrosis vs recurrence

Need for Contrast

Gadolinium contrast often needed

Iodinated contrast usually needed

Contraindications

Pacemaker, severe claustrophobia, metal implants

Generally safe for most patients

Radiographic Signs of Laryngeal Cancer

Mass or Tumor

  • Focal soft tissue mass in larynx

Asymmetry

  • Vocal cord or laryngeal structure asymmetry

Mucosal Thickening

  • Localized or diffuse thickening

Loss of Normal Fat Planes

  • Blurring/loss of fat around laryngeal spaces (paraglottic, pre-epiglottic)

Vocal Cord Fixation

  • Incomplete or absent vocal cord motion (seen dynamically or inferred from findings)

Cartilage Changes

Sclerosis (early invasion) 

  • Erosion/destruction (advanced invasion)

Airway Narrowing

  • Reduction in laryngeal airway size (especially at glottis/subglottis)

Lymphadenopathy

  • Enlarged, possibly necrotic cervical lymph nodes (levels II–IV)

Enhancement Patterns

  • Irregular or asymmetric enhancement after contrast

Subglottic Extension

  • Mass extending below the vocal cords into subglottic space

Involvement of Adjacent Structures

  • Tumor reaching thyroid gland, strap muscles, trachea, esophagus

Laryngeal Cancer Staging Radiology

Laryngeal cancer staging depends on:

  • Tumor (T): size, location, spread
  • Node (N): regional lymph node involvement
  • Metastasis (M): distant spread

Radiologic T-Staging of Laryngeal Cancer

  • T1: Small tumor, confined, early stage
  • T2: Local extension
  • T3: More aggressive but still potentially curable locally
  • T4(Moderately Advanced): "Operable" advanced cancer
  • T5(Very Advanced): Unresectable, very poor prognosis

Radiologic N-Staging (Nodes)

  • N0: No lymph node metastasis
  • N1: Single ipsilateral node ≤ 3 cm
  • N2: Single node > 3 cm but ≤ 6 cm, or multiple nodes, none > 6 cm
  • N3: Node > 6 cm in greatest dimension

Radiologic M-Staging (Distant Metastasis)

  • M0: No distant metastasis
  • M1: Distant metastasis (common sites: lungs, liver, bones)

Ultrasound Laryngeal Cancer

Ultrasonography can be used as a modality for assessment of neck lymph nodes. It can also differentiate between benign and malignant nodes, aid in decision-making regarding biopsy in an axillary node.

Main Uses of Ultrasound in Laryngeal Cancer:

  • Cervical Lymph Node Assessment
  • Preoperative Mapping
  • Post-Treatment Surveillance
  • Thyroid Cartilage Invasion (in selective cases)
  • Guided Biopsy

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