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Invasion of laryngeal cartilage has long been considered as a contraindication to radiation treatment and to all types of conservation surgery. With the advent of axial imaging techniques clarification of the submucosal extent of disease became possible. However, controversies regarding diagnosis (preferred modality, accuracy of detection of cartilage invasion) and treatment of cartilage invasion (Is cartilage invasion really a contraindication for irradiation treatment?) arose. Based on currently accepted criteria, CT appears to be more specific in detecting neoplastic cartilage invasion than MRI, but tends to underestimate invasion and may therefore result in undertreatment. Magnetic resonance has a higher sensitivity than CT for detection of cartilage invasion. The superiority of MRI lies in its ability to detect intracartilaginous tumor spread. Unfortunately, MR findings suggesting neoplastic cartilage invasion …