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van Staalduinen EK, Matthews R, Khan A, Punn I, Cattell RF, Li H, Franceschi A, Samara GJ, Czerwonka L, Bangiyev L, Duong TQ. Improved Cervical Lymph Node Characterization among Patients with Head and Neck Squamous Cell Carcinoma Using MR Texture Analysis Compared to Traditional FDG-PET/MR Features Alone. Diagnostics (Basel) 2023; 14:71. [PMID: 38201380 PMCID: PMC10802850 DOI: 10.3390/diagnostics14010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/24/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
Accurate differentiation of benign and malignant cervical lymph nodes is important for prognosis and treatment planning in patients with head and neck squamous cell carcinoma. We evaluated the diagnostic performance of magnetic resonance image (MRI) texture analysis and traditional 18F-deoxyglucose positron emission tomography (FDG-PET) features. This retrospective study included 21 patients with head and neck squamous cell carcinoma. We used texture analysis of MRI and FDG-PET features to evaluate 109 histologically confirmed cervical lymph nodes (41 metastatic, 68 benign). Predictive models were evaluated using area under the curve (AUC). Significant differences were observed between benign and malignant cervical lymph nodes for 36 of 41 texture features (p < 0.05). A combination of 22 MRI texture features discriminated benign and malignant nodal disease with AUC, sensitivity, and specificity of 0.952, 92.7%, and 86.7%, which was comparable to maximum short-axis diameter, lymph node morphology, and maximum standard uptake value (SUVmax). The addition of MRI texture features to traditional FDG-PET features differentiated these groups with the greatest AUC, sensitivity, and specificity (0.989, 97.5%, and 94.1%). The addition of the MRI texture feature to lymph node morphology improved nodal assessment specificity from 70.6% to 88.2% among FDG-PET indeterminate lymph nodes. Texture features are useful for differentiating benign and malignant cervical lymph nodes in patients with head and neck squamous cell carcinoma. Lymph node morphology and SUVmax remain accurate tools. Specificity is improved by the addition of MRI texture features among FDG-PET indeterminate lymph nodes. This approach is useful for differentiating benign and malignant cervical lymph nodes.
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Affiliation(s)
- Eric K. van Staalduinen
- Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, Bronx, NY 10467, USA
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Robert Matthews
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Adam Khan
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Isha Punn
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Renee F. Cattell
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Haifang Li
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Ana Franceschi
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Ghassan J. Samara
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Lukasz Czerwonka
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Lev Bangiyev
- Stony Brook Medicine, Department of Radiology, Stony Brook, NY 11794, USA (A.F.); (L.B.)
| | - Tim Q. Duong
- Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, Bronx, NY 10467, USA
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Noldner C, Bae J, Kartsonis W, Cattell R, Patel M, Pierce A, Sehgal G, Soff S, Ryu S, Czerwonka L, Prasanna P, Mani K. Pre-Radiation CT-Based Radiomic Features Predict Locoregional and Distant Failure in Locally Advanced Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Czerwonka L, Bissada E, Goldstein DP, Wood RE, Lam EW, Yu E, Lazinski D, Irish JC. High-resolution cone-beam computed tomography for assessment of bone invasion in oral cancer: Comparison with conventional computed tomography. Head Neck 2017; 39:2016-2020. [DOI: 10.1002/hed.24858] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 01/31/2017] [Accepted: 05/01/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Lukasz Czerwonka
- Department of Surgery; Division of Otolaryngology - Head and Neck Surgery, Stony Brook University; Stony Brook New York
| | - Eric Bissada
- Department of Otolaryngology - Head and Neck Surgery; University of Toronto; Toronto Ontario Canada
| | - David P. Goldstein
- Department of Otolaryngology - Head and Neck Surgery; University of Toronto; Toronto Ontario Canada
| | - Robert E. Wood
- Department of Dental Oncology; Princess Margaret Hospital; Toronto Ontario Canada
| | - Ernest W. Lam
- Division of Oral Radiology; University of Toronto Faculty of Dentistry; Toronto Ontario Canada
| | - Eugene Yu
- Department of Medical Imaging; Division of Neuroimaging, University of Toronto; Toronto Ontario Canada
| | - Dorothy Lazinski
- Department of Medical Imaging; Division of Neuroimaging, University of Toronto; Toronto Ontario Canada
| | - Jonathan C. Irish
- Department of Otolaryngology - Head and Neck Surgery; University of Toronto; Toronto Ontario Canada
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Czerwonka L, De Santis RJ, Horowitz G, Hong M, Orsini M, Enepekides D, Goldstein DP, Dort J, Higgins K. Staging cutaneous squamous cell carcinoma metastases to the parotid gland. Laryngoscope 2017; 127:2063-2069. [PMID: 28295401 DOI: 10.1002/lary.26544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 01/16/2017] [Accepted: 01/25/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The staging of cutaneous squamous cell cancers (cSCC) was revised by the American Joint Committee on Cancer in 2010 to incorporate known prognostic factors and expand the N (node) category. The purpose of this study was to validate this staging system using a North American cohort, and to compare it to the O'Brien P (Parotid) and N staging system. METHODS An exhaustive collaborative database search was performed for all patients with cSCC metastasis to the parotid gland treated at three major Canadian tertiary referral centers from December 1999 to March 2015. The data collected for each patient included overall survival; disease-free survival; tumor, node, and metastasis) staging; and postoperative radiation status. Post-hoc analysis was completed to discern the strongest prognostic factors of survival as they relate to the abovementioned staging systems. RESULTS Of 136 patients identified, 80% had a documented history of previously treated head and neck cSCC an average of 27 months prior to presentation. Average size of the parotid lesion at recurrence was 4.5 cm. Ninety-six percent of patients underwent surgical resection of the parotid metastasis. Five-year overall and disease-free survival is 79% and 55%, respectively. Only cSCC staging and cSCC-N category had statistically significant differences between groups. cSCC staging had the largest percentage of variation in overall survival explained. CONCLUSION Patients with cSCC metastasis to the parotid gland proved to have a moderate survival rate, despite presenting with advanced disease. cSCC staging in the setting of parotid metastasis, despite its limitations, currently offers the most predictive staging system available. LEVEL OF EVIDENCE 4. Laryngoscope, 127:2063-2069, 2017.
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Affiliation(s)
- Lukasz Czerwonka
- Department of Otolaryngology (ENT), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Robert J De Santis
- Department of Otolaryngology (ENT), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Gilad Horowitz
- Department of Otolaryngology (ENT), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Michael Hong
- Department of Otolaryngology (ENT), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mario Orsini
- Department of Otolaryngology (ENT), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Danny Enepekides
- Department of Otolaryngology (ENT), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - David P Goldstein
- Department of Otolaryngology (ENT), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Joe Dort
- Cumming School of Medicine, University of Calgary, Health Sciences Centre, Calgary, Alberta, Canada
| | - Kevin Higgins
- Department of Otolaryngology (ENT), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Czerwonka L, Freeman J, McIver B, Randolph GW, Shah JP, Shaha AR, Sherman SI, Tuttle RM, Witterick IJ. Summary of proceedings of the second World Congress on Thyroid Cancer. Head Neck 2014; 36:917-20. [PMID: 24677329 DOI: 10.1002/hed.23631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 02/17/2014] [Indexed: 12/30/2022] Open
Abstract
The second World Congress on Thyroid Cancer was held from July 10 to July 14, 2013, in Toronto, Canada. Its purpose was to provide a platform for the multidisciplinary discussion on research, education, and patient management of thyroid malignancy. Herein, we summarize the latest major trends and controversies within the field of thyroid oncology as discussed in the Congress including the use of ultrasound, standardization of cytology, role of molecular testing, treatment options for small recurrence including ablation and observation, management of recurrent laryngeal nerve injury, importance of identification of the external branch of the superior laryngeal nerve, role of minimally invasive thyroid surgery, trends in radioactive iodine treatment, advancements in targeted agents, and the importance of personalizing treatment to individual patients.
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Affiliation(s)
- Lukasz Czerwonka
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
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Abstract
HYPOTHESIS Posterior positioning of medialization thyroplasty provides the best acoustic and aerodynamic outcomes. STUDY DESIGN Ex vivo excised canine larynx. METHODS Unilateral thyroplasty windows were cut in the thyroid cartilages of 10 excised canine larynges. Each larynx was mounted on an artificial lung and the vocal fold opposite the thyroid window was adducted by medializing its arytenoid cartilage. Then, medialization thyroplasty was simulated with a probe placed anterior, central, and posterior in the thyroid window. The glottal area, airway reduction, medialization force, phonation threshold pressure and flow, aerodynamic power, intensity, efficiency, jitter, shimmer, and signal-to-noise ratio (SNR) were measured at each medialization position. RESULTS Posterior medialization probe placement minimized the glottal area, provided the best voice as determined by perturbation measures and SNR, reduced the work of phonation, and increased efficiency. Anterior and middle probe placement minimized the work of phonation but provided only modest gains in sound quality and decreased sound intensity. Medializing the vocal fold with posterior probe placement required twice as much force as central and anterior probe placement. CONCLUSIONS The results suggest that posterior medialization provides the greatest improvement in acoustic parameters and efficiency in patients who can tolerate the airway reduction. Middle and anterior medialization can decrease work of phonation, but in this experiment objective improvement in sound quality was limited. Subtle changes in displacement shim contour, especially in middle and anterior locations, have a substantial impact on voice outcome, affirming the value of intraoperative voice assessment.
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Affiliation(s)
- Lukasz Czerwonka
- Department of Surgery, Division of Otolaryngology Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Zhang Y, Czerwonka L, Tao C, Jiang JJ. A biphasic theory for the viscoelastic behaviors of vocal fold lamina propria in stress relaxation. J Acoust Soc Am 2008; 123:1627-36. [PMID: 18345850 DOI: 10.1121/1.2831739] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
In this study, a biphasic theory is applied to investigate the viscoelastic behaviors of vocal fold lamina propria during stress relaxation. The vocal fold lamina propria tissue is described as a biphasic material composed of a solid phase and an interstitial fluid phase. The biphasic theory reveals the interaction between the solid and the fluid. For the one-dimensional case, the analytical solutions of solid displacement, fluid velocity, and stress are derived. The biphasic theory predicts the stress relaxation of the vocal fold lamina propria. The quasilinear viscoelastic model as well as its higher-order elastic parameters can be derived from this biphasic theory. Furthermore, the fluid is found to support the majority of the stress at the early stage of stress relaxation; however, when the time becomes sufficiently large, the solid eventually bears all the stress. The early fluid stress support is much higher than the eventual solid support and may be important for understanding the effects of dehydration on tissue damage. By considering the solid-fluid structure of the vocal fold lamina propria, the biphasic theory allows for a more physical theory of tissue viscoelasticity than a single phase solid description and may provide a valuable physical mechanism for the observed vocal fold rheologic behaviors.
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Affiliation(s)
- Yu Zhang
- Department of Surgery, Division of Otolaryngology Head and Neck Surgery, University of Wisconsin Medical School, Madison, Wisconsin 53792-7375, USA
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