Abstract:
Introduction. Digital tomosynthesis is a relatively new imaging modality that is already used in the diagnosis of breast
cancer and has shown promising results in evaluating patients with pulmonary, osteoarticular, and other pathologies.
However, up to date, there are no published studies related to the usefulness of digital tomosynthesis in the evaluation of
patients with laryngeal cancer. The purpose of this study was to evaluate the clinical role of digital tomosynthesis in the
diagnosis of laryngeal cancer and compare the imaging results with those obtained by digital radiography and computed
tomography.
Material and methods. The study was carried out between 2015 and 2019 at the Institute of Oncology in the Republic
of Moldova and included 253 consecutive patients with laryngeal cancer referred to the Institute of Oncology during this
period. All patients underwent digital radiography and digital tomosynthesis investigations. In 41 patients who provided
written informed consent, computed tomography was performed. The results of all imaging investigations were compared.
Results. The statistical analysis revealed a high degree of agreement and a strong linear correlation between the data obtained with digital tomosynthesis and computed tomography, as well as concordance correlation coefficients for different
parameters between 0.63 and 1.0 (mean value = 0.82±0.11). For comparison, the concordance correlation coefficients for
the same parameters obtained for digital radiography versus computed tomography ranged between 0.08 and 0.93 (mean
value = 0.43±0.25). An updated imaging algorithm that includes digital tomosynthesis has also been proposed for investigating patients with suspected laryngeal cancer.
Conclusions. The study demonstrated the usefulness of digital tomosynthesis for the evaluation of patients with laryngeal
cancer. When compared to computed tomography, which is considered the gold standard, digital tomosynthesis revealed
a much higher performance compared to digital radiography. Considering the availability of low-dose protocols for digital
tomosynthesis, the modality might also be helpful for laryngeal cancer screening in a high-risk population. However, new
studies are also required to confirm our findings and define the place of digital tomosynthesis in the imaging algorithm
for patients with laryngeal cancer.
