Radiomics in laryngeal squamous cell carcinoma: state of the art

Laryngeal squamous cell carcinoma (LSCC) is one of the most common malignancies of the head and neck, and accurate staging is essential for optimal therapeutic decision-making. However, discrepancies between clinical-radiological staging and pathological findings, particularly in the assessment of thyroid cartilage invasion and lymph node involvement, may result in inappropriate treatment decisions. Radiomics has recently emerged as a quantitative imaging approach capable of extracting high-dimensional features from medical images, providing objective biomarkers that reflect tumour heterogeneity beyond visual assessment. This narrative review summarises current evidence on radiomics applications in LSCC, including staging, cartilage invasion assessment, nodal evaluation, and prognostic stratification, and outlines the main steps of the radiomic workflow together with current methodological challenges. Recent studies indicate that radiomics, particularly when integrated with deep learning and clinical data, improves diagnostic and prognostic performance compared with conventional imaging alone. However, methodological heterogeneity and limited external validation still restrict routine clinical implementation, and further standardisation and prospective multicentre validation are required before widespread clinical adoption.