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Diagnostic accuracy of imaging modalities for detecting residual or recurrent laryngeal cancer after (Chemo)radiotherapy: A systematic review and meta-analysis
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Y. Zhan   , H. Cao , X. Shan , X. Tai |
| Department of Otolaryngology, The Air Force Hospital of the Northern Theater Command of the Chinese People’s Liberation Army, Shenyang, Liaoning, China , entdoctor463@163.com |
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Abstract: (11 Views) |
Background: Differentiating residual or recurrent laryngeal carcinoma (RLC) from post-treatment changes after (chemo)radiotherapy remains a clinical challenge. This systematic review and meta-analysis evaluate the diagnostic performance of the imaging modalities most commonly used in this setting. Materials and Methods: We searched PubMed, Embase, Scopus, Google Scholar and Web of Science through December 2025 for studies assessing computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), PET/CT or narrow band imaging (NBI) in adults with laryngeal cancer treated with (chemo)radiotherapy. Histopathology or clinical follow-up served as the reference standard. Pooled sensitivity, specificity, diagnostic odds ratio (DOR) and area under the summary receiver operating characteristic curve (AUC) were calculated using bivariate random-effects and hierarchical summary receiver operating characteristic (HSROC) models. Risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Results: Thirty-nine studies (4,126 patients) met the inclusion criteria. PET/CT showed the highest pooled sensitivity (92%) and specificity (88%), with a DOR of 91.3 (95% CI 68.4–122.7) and an AUC of 0.95. MRI achieved a sensitivity 86% and a specificity 83%; CT achieved 77% and 75%. NBI achieved a sensitivity 89% and a specificity 84% in three small prospective cohorts limited to mucosal lesions. Heterogeneity was moderate to high (I² 48–72%), partly explained by study design, timing of imaging and choice of reference standard. Deeks’ test showed no significant publication bias. Conclusion: PET/CT is the most accurate imaging modality for detecting residual or recurrent laryngeal cancer after (chemo)radiotherapy. MRI and NBI have valuable adjunctive roles. Future work should prioritise standardised protocols, prospective multicentre validation and evaluation of multimodal strategies. |
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| Keywords: Laryngeal neoplasms, neoplasm recurrence, chemoradiotherapy, PET, CT, MRI, narrow band imaging, meta-analysis. |
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Full-Text [PDF 1257 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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