CT and MRI Evaluation of Nasal Adenocarcinoma Local Extent

BACKGROUND AND PURPOSE: The radiological evaluation of the local extent of nasal adenocarcinomas may be complex. Objectives of this study were to describe the local extent of adenocarcinomas of the olfactory cleft relatively to the natural barriers of the sino-nasal cavities and to assess the reproducibility of this evaluation. METHODS: We retrospectively analysed a 5-year series of pre-op CT and MRI images of patients operated on nasal adenocarcinoma. The tumoral extensions were staged according to their relationships with the surrounding anatomical barriers (from d1=at distance from the barriers to d4b=invasion of the adjacent organ with resectability impossible or uncertain) by two teams (each composed of one ENT and one radiologist), who blindly analysed the radiological records twice, using a standardized grid. Reproducibility was evaluated with the kappa test. RESULTS: 30 radiological records were analysed. Results support that the origin of woodworkers' adenocarcinomas is in the olfactory cleft. Reproducibility was excellent for all the criteria (K=0.8) except for the relation with sphenoid sinus (K=0.5). CONCLUSIONS: This study proposes to stage, in a precise and reproducible manner, the local extension of nasal adenocarcinomas according to their relationships with the surrounding barriers of the olfactory-ethmoidal cavities. This method of staging may help for rationalized therapeutic decision.