Clinical trial · Observational
p-PHOTOLARYNX- ANTHEM: Photon-Counting CT in Laryngeal Cancer Staging
p-PHOTOLARYNX- ANTHEM: Pilot Photon-Counting CT Evaluation of the Paraglottic Space and Cartilage Involvement in Laryngeal Cancer
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Laryngeal cancer can affect speaking, swallowing, and breathing. Treatment selection depends on accurately defining tumor spread within the larynx, particularly invasion of the paraglottic space, thyroid cartilage, and subglottic region. Understaging may lead to insufficient treatment and recurrence, whereas overstaging may result in unnecessarily aggressive surgery and impaired quality of life. CT and MRI are routinely used for local staging, but both have limitations. Conventional CT may have limited soft-tissue and cartilage contrast, while MRI is more time-consuming, motion-sensitive, and not feasible in all patients. Photon-counting CT (PCCT) is a new CT technology offering higher spatial resolution, improved tissue contrast, and reconstructions at different energy levels. This study evaluates whether PCCT performed during phonation, while the patient produces a sustained sound, can improve local staging of laryngeal cancer. Phonation may better separate and display laryngeal structures, improving detection of tumor extension. The main hypothesis is that optimized phonation PCCT reconstructions can assess tumor spread more accurately than standard CT and may approach MRI performance. Participants undergo PCCT as part of routine preoperative imaging. Images are reconstructed using different settings and reviewed by radiologists for image quality and tumor extension. When surgery is performed, imaging findings are compared with surgical and histopathological results. The study aims to identify the most accurate PCCT reconstruction strategy to support better treatment planning in laryngeal cancer.
Conditions
Conditions (2)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Laryngeal Cancer | Malignant Laryngeal Neoplasm | CURATED_EXACT | 0.92 |
| Laryngeal Carcinoma | Laryngeal Carcinoma | ONTOLOGY_EXACT | 0.98 |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Photon Counting Computed Tomography | Diagnostic Test | — | UNRESOLVED |
Design
Arms and outcomes
Arms (1)
- label
- Biopsy-Proven Laryngeal Squamous Cell Carcinoma Patients
- description
- A total of sixty patients, with biopsy-proven and clinical laryngeal squamous cell carcinoma
- interventionNames
- Diagnostic Test: Photon Counting Computed Tomography
Primary outcomes (2)
- measure
- Diagnostic Accuracy of Phonation Photon-Counting CT (PCCT) for Local Tumor Extension
- timeFrame
- From completion of baseline phonation PCCT imaging to histopathological correlation, assessed up to 12 weeks.
- description
- Description: To evaluate the diagnostic accuracy of phonation PCCT in identifying paraglottic space invasion, thyroid cartilage invasion (including distinction between inner cortical erosion and full-thickness invasion), and subglottic extension, using surgical and histopathological findings as the reference standard.
- measure
- Identification of the Optimal PCCT Reconstruction for Local Staging
- timeFrame
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
1\. SELECTION CRITERIA Inclusion Criteria * Adults (≥18 years) * Biopsy-proven laryngeal cancer squamous cell carcinoma * Candidate for surgical staging able to undergo PCCT Exclusion criteria * Renal failure * Allergy to contrast medium * Refusal of informed consent * Lack of histopathologic confirmation * Histopathologic diagnosis of non laryngeal tumors * Poor image quality due to severe artifacts
References
Publications (10)
- BACKGROUNDKuno H, Sakamaki K, Fujii S, Sekiya K, Otani K, Hayashi R, Yamanaka T, Sakai O, Kusumoto M. Comparison of MR Imaging and Dual-Energy CT for the Evaluation of Cartilage Invasion by Laryngeal and Hypopharyngeal Squamous Cell Carcinoma. AJNR Am J Neuroradiol. 2018 Mar;39(3):524-531. doi: 10.3174/ajnr.A5530. Epub 2018 Jan 25. PMID 29371253
- BACKGROUNDPreda L, Conte G, Bonello L, Giannitto C, Tagliabue E, Raimondi S, Ansarin M, De Benedetto L, Cattaneo A, Maffini F, Bellomi M. Diagnostic accuracy of surface coil MRI in assessing cartilaginous invasion in laryngeal tumours: Do we need contrast-agent administration? Eur Radiol. 2017 Nov;27(11):4690-4698. doi: 10.1007/s00330-017-4840-x. Epub 2017 May 5. PMID 28477165
- BACKGROUNDBecker M, Zbaren P, Casselman JW, Kohler R, Dulguerov P, Becker CD. Neoplastic invasion of laryngeal cartilage: reassessment of criteria for diagnosis at MR imaging. Radiology. 2008 Nov;249(2):551-9. doi: 10.1148/radiol.2492072183. PMID 18936314
- BACKGROUNDYu Z, Leng S, Kappler S, Hahn K, Li Z, Halaweish AF, Henning A, McCollough CH. Noise performance of low-dose CT: comparison between an energy integrating detector and a photon counting detector using a whole-body research photon counting CT scanner. J Med Imaging (Bellingham). 2016 Oct;3(4):043503. doi: 10.1117/1.JMI.3.4.043503. Epub 2016 Dec 14. PMID 28018936
- BACKGROUNDBecker M, Zbären P, Casselman JW, et al. MRI in the Preoperative Staging of Laryngeal Cancer. AJNR. 2010;31(4):592-599. doi:10.3174/ajnr.A1912
- BACKGROUNDCastelijns JA, van den Brekel MW. Imaging of Laryngeal Cancer. Eur J Radiol. 2008;66(3):501-517. doi:10.1016/j.ejrad.2008.01.046
- BACKGROUNDLeng S, Bruesewitz M, Tao S, et al. Photon-Counting CT: Impact on Noise, Spatial Resolution, and Image Quality. Radiology. 2020;297(3):738-746. doi:10.1148/radiol.2020201407
- BACKGROUNDLi H, Yadava G, Procopiou M, et al. Photon-Counting Detector CT: Clinical Applications of an Emerging Technology. Radiographics. 2022;42(5):1439-1456. doi:10.1148/rg.220014