BACKGROUND AND PURPOSE: Although sonographic evaluation of cervical adenopathy by use of size criteria is effective, the sensitivity and specificity fall short of that required to make adequate judgments regarding neck dissection. Therefore, we tested whether the combined use of size criteria and Doppler sonographic findings would improve the predictive ability for metastatic cervical nodes. METHODS: We analyzed 338 histologically proved cervical lymph nodes (108 metastatic and 230 nonmetastatic) in 73 patients with head and neck cancer. The sonographic topography of the nodes was compared with dissected specimens, and their position in the neck was categorized into three levels (I, II, and III+IV). The diagnostic accuracy of sonography was evaluated by using the single criterion of short-axis diameter of the node or by the combined criteria of short-axis diameter and Doppler blood flow features (the absence or presence of normal hilar flow). RESULTS: As compared with the single criterion of short-axis nodal diameter, the combined criteria of nodal size and Doppler blood flow patterns increased the diagnostic accuracy of sonography at all levels in the neck. Accordingly, the best cut-off values were improved to 6, 7, and 5 mm for nodes at levels I, II, and III+IV, respectively. In addition, the combined criteria yielded high sensitivites (> or = 89%) and specificities (> or = 94%). CONCLUSION: Hilar blood flow information obtained by Doppler sonography significantly improves diagnostic accuracy for the detection of nodes metastatic from head and neck squamous cell carcinoma.
BACKGROUND AND PURPOSE: Although sonographic evaluation of cervical adenopathy by use of size criteria is effective, the sensitivity and specificity fall short of that required to make adequate judgments regarding neck dissection. Therefore, we tested whether the combined use of size criteria and Doppler sonographic findings would improve the predictive ability for metastatic cervical nodes. METHODS: We analyzed 338 histologically proved cervical lymph nodes (108 metastatic and 230 nonmetastatic) in 73 patients with head and neck cancer. The sonographic topography of the nodes was compared with dissected specimens, and their position in the neck was categorized into three levels (I, II, and III+IV). The diagnostic accuracy of sonography was evaluated by using the single criterion of short-axis diameter of the node or by the combined criteria of short-axis diameter and Doppler blood flow features (the absence or presence of normal hilar flow). RESULTS: As compared with the single criterion of short-axis nodal diameter, the combined criteria of nodal size and Doppler blood flow patterns increased the diagnostic accuracy of sonography at all levels in the neck. Accordingly, the best cut-off values were improved to 6, 7, and 5 mm for nodes at levels I, II, and III+IV, respectively. In addition, the combined criteria yielded high sensitivites (> or = 89%) and specificities (> or = 94%). CONCLUSION: Hilar blood flow information obtained by Doppler sonography significantly improves diagnostic accuracy for the detection of nodes metastatic from head and neck squamous cell carcinoma.
Authors: R P Takes; P Knegt; J J Manni; C A Meeuwis; H A Marres; H A Spoelstra; M F de Boer; I Bruaset; J A van Oostayen; J S Laméris; R H Kruyt; F B Joosten; J H van Krieken; F T Bosman; S C Henzen-Logmans; J M Wiersma-van Tilburg; J Hermans; R J Baatenburg de Jong Journal: Radiology Date: 1996-03 Impact factor: 11.105
Authors: F Dragoni; C Cartoni; E Pescarmona; F Chiarotti; M Puopolo; E Orsi; P Pignoloni; C De Gregoris; F Mandelli Journal: Cancer Date: 1999-06-01 Impact factor: 6.860
Authors: S S Yom; A S Garden; G A Staerkel; L E Ginsberg; W H Morrison; E M Sturgis; D I Rosenthal; J N Myers; B S Edeiken-Monroe Journal: AJNR Am J Neuroradiol Date: 2011-07-14 Impact factor: 3.825
Authors: Dae Young Yoon; Hee Sung Hwang; Suk Ki Chang; Young-Soo Rho; Hwoe Young Ahn; Jin Hwan Kim; In Jae Lee Journal: Eur Radiol Date: 2008-10-09 Impact factor: 5.315