Accuracy of palpation, ultrasonography, and computed tomography in the evaluation of metastatic cervical lymph nodes in head and neck cancer

Abstract

Introduction:India accounts for the majority of oral cancer cases occurring worldwide. The metastasis of oral cancer to the regional lymph nodes and distant sites determines the prognosis and the survival rate of this disease.Objectives:The aim and objectives of this study were to evaluate the accuracy of preoperative clinical methods such as palpation, ultrasonography (USG), and computed tomography (CT) in comparison with postoperative histopathological findings in determination of metastatic cervical lymph nodes and also to assess whether combining these techniques increases the specificity and sensitivity of lymph node metastasis in oral squamous cell carcinoma (SCC).Methodology:Totally, 26 consecutive biopsy proven cases of oral SCC were included, and the nodal status was evaluated by palpation, CT and ultrasound (US) and confirmed by histopathological examination. The results were presented in terms of sensitivity, specificity, predictive values, accuracy, and P value.Results:Palpation, USG, and CT findings were compared with histopathologic findings by Fisher's exact test and the “P” value for palpation, US and CT were 0.003, 0.000, 0.000, respectively, which are statistically significant.Conclusion:US examination combined with CT gives a better assessment of the neck for nodal metastasis.

Accuracy of diagnostic aids in oral squamous cell carcinoma: A comparative study

“…This is in accordance with the literature reporting an accuracy range of (68%-92.30%) by Geetha et al in 2010, 1 (87.67%) Shalinder et al in 2016 12 , and (87.93%) Sharma et al in 2018. 20 Our result was in contrary to studies done by Shetty et al in 2015 2 who gave a sensitivity (31.81%), specificity (93.75%) and accuracy (76.28%) and Ashraf et al in 2011 7 gave a sensitivity (83%), specificity (93%) and accuracy (77.2%), which showed lower value in comparison with our study. A study done by Niranjan 15 reported sensitivity (86.7%), specificity (97%) and accuracy (96.1%) showing a comparatively higher value in comparison with our study.…”

“…Our study showed a sensitivity (60%), specificity (90.9%), positive predictive value (83.3%) and negative predictive value (100%) when we compared clinical palpation with histopathology in diagnosing a node as metastatic, giving an accuracy of 70.9%. The result of our study is in comparison with the accuracy range value of 60%–80% reported by Geetha et al in 2010 1 and Fischbein et al in 2003 11 (70%) and Shetty et al in 2015 2 (71.43%). The sensitivity and specificity value of our study was comparatively higher when compared with the study by Sundar et al in 2007 12 who reported (54.5%), Haberal et al in 2004 13 (64%) and specificity (85%) and Merritt et al in 1997 14 who reported the sensitivity (75%) and specificity (83%).…”

Accuracy of diagnostic aids in oral squamous cell carcinoma: A comparative study

“…This is in accordance with the literature reporting an accuracy range of (68%-92.30%) by Geetha et al in 2010, 1 (87.67%) Shalinder et al in 2016 12 , and (87.93%) Sharma et al in 2018. 20 Our result was in contrary to studies done by Shetty et al in 2015 2 who gave a sensitivity (31.81%), specificity (93.75%) and accuracy (76.28%) and Ashraf et al in 2011 7 gave a sensitivity (83%), specificity (93%) and accuracy (77.2%), which showed lower value in comparison with our study. A study done by Niranjan 15 reported sensitivity (86.7%), specificity (97%) and accuracy (96.1%) showing a comparatively higher value in comparison with our study.…”

“…Our study showed a sensitivity (60%), specificity (90.9%), positive predictive value (83.3%) and negative predictive value (100%) when we compared clinical palpation with histopathology in diagnosing a node as metastatic, giving an accuracy of 70.9%. The result of our study is in comparison with the accuracy range value of 60%–80% reported by Geetha et al in 2010 1 and Fischbein et al in 2003 11 (70%) and Shetty et al in 2015 2 (71.43%). The sensitivity and specificity value of our study was comparatively higher when compared with the study by Sundar et al in 2007 12 who reported (54.5%), Haberal et al in 2004 13 (64%) and specificity (85%) and Merritt et al in 1997 14 who reported the sensitivity (75%) and specificity (83%).…”

Predicting Adverse Histopathology and Need for Postsurgical Adjuvant Therapy for Human Papilloma Virus–Associated Oropharynx Carcinoma

“…20 The imperfect sensitivity of head and neck examination and imaging studies such as ultrasound, computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT likely contributes to this discrepancy in clinicopathologic stages. [21][22][23] Our study reiterates previous reports demonstrating that clinical assessment of ENE can be inaccurate. 24,25 For HPV1 OPSCC specifically, the features of irregular nodal margins and the absence of perinodal fat plane on CT scans used to assess cENE designation were found to have PPVs of 80% to 82% and NPVs of 64% to 73%.…”

Diagnostic role of ultrasound elastography on lymph node metastases in patients with head and neck cancer

“…True detectability rate (accuracy rate) of neck metastasis by palpation has been reported around 70%. 8 , 9 , 10 , 11 In our study, the sensitivity, specificity and accuracy rates of palpation were 47%, 92% and 66.7% respectively. These values are certainly quite insufficient to make accurate assessments.…”

Accuracy of diagnostic aids in oral squamous cell carcinoma: A comparative study

“…This is in accordance with the literature reporting an accuracy range of (68%-92.30%) by Geetha et al in 2010, 1 (87.67%) Shalinder et al in 2016 12 , and (87.93%) Sharma et al in 2018. 20 Our result was in contrary to studies done by Shetty et al in 2015 2 who gave a sensitivity (31.81%), specificity (93.75%) and accuracy (76.28%) and Ashraf et al in 2011 7 gave a sensitivity (83%), specificity (93%) and accuracy (77.2%), which showed lower value in comparison with our study. A study done by Niranjan 15 reported sensitivity (86.7%), specificity (97%) and accuracy (96.1%) showing a comparatively higher value in comparison with our study.…”

“…Our study showed a sensitivity (60%), specificity (90.9%), positive predictive value (83.3%) and negative predictive value (100%) when we compared clinical palpation with histopathology in diagnosing a node as metastatic, giving an accuracy of 70.9%. The result of our study is in comparison with the accuracy range value of 60%–80% reported by Geetha et al in 2010 1 and Fischbein et al in 2003 11 (70%) and Shetty et al in 2015 2 (71.43%). The sensitivity and specificity value of our study was comparatively higher when compared with the study by Sundar et al in 2007 12 who reported (54.5%), Haberal et al in 2004 13 (64%) and specificity (85%) and Merritt et al in 1997 14 who reported the sensitivity (75%) and specificity (83%).…”

Predicting Adverse Histopathology and Need for Postsurgical Adjuvant Therapy for Human Papilloma Virus–Associated Oropharynx Carcinoma

“…20 The imperfect sensitivity of head and neck examination and imaging studies such as ultrasound, computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT likely contributes to this discrepancy in clinicopathologic stages. [21][22][23] Our study reiterates previous reports demonstrating that clinical assessment of ENE can be inaccurate. 24,25 For HPV1 OPSCC specifically, the features of irregular nodal margins and the absence of perinodal fat plane on CT scans used to assess cENE designation were found to have PPVs of 80% to 82% and NPVs of 64% to 73%.…”

Diagnostic role of ultrasound elastography on lymph node metastases in patients with head and neck cancer

“…True detectability rate (accuracy rate) of neck metastasis by palpation has been reported around 70%. 8 , 9 , 10 , 11 In our study, the sensitivity, specificity and accuracy rates of palpation were 47%, 92% and 66.7% respectively. These values are certainly quite insufficient to make accurate assessments.…”

Accuracy of diagnostic aids in oral squamous cell carcinoma: A comparative study

“…This is in accordance with the literature reporting an accuracy range of (68%-92.30%) by Geetha et al in 2010, 1 (87.67%) Shalinder et al in 2016 12 , and (87.93%) Sharma et al in 2018. 20 Our result was in contrary to studies done by Shetty et al in 2015 2 who gave a sensitivity (31.81%), specificity (93.75%) and accuracy (76.28%) and Ashraf et al in 2011 7 gave a sensitivity (83%), specificity (93%) and accuracy (77.2%), which showed lower value in comparison with our study. A study done by Niranjan 15 reported sensitivity (86.7%), specificity (97%) and accuracy (96.1%) showing a comparatively higher value in comparison with our study.…”

“…Our study showed a sensitivity (60%), specificity (90.9%), positive predictive value (83.3%) and negative predictive value (100%) when we compared clinical palpation with histopathology in diagnosing a node as metastatic, giving an accuracy of 70.9%. The result of our study is in comparison with the accuracy range value of 60%–80% reported by Geetha et al in 2010 1 and Fischbein et al in 2003 11 (70%) and Shetty et al in 2015 2 (71.43%). The sensitivity and specificity value of our study was comparatively higher when compared with the study by Sundar et al in 2007 12 who reported (54.5%), Haberal et al in 2004 13 (64%) and specificity (85%) and Merritt et al in 1997 14 who reported the sensitivity (75%) and specificity (83%).…”

Predicting Adverse Histopathology and Need for Postsurgical Adjuvant Therapy for Human Papilloma Virus–Associated Oropharynx Carcinoma

“…20 The imperfect sensitivity of head and neck examination and imaging studies such as ultrasound, computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT likely contributes to this discrepancy in clinicopathologic stages. [21][22][23] Our study reiterates previous reports demonstrating that clinical assessment of ENE can be inaccurate. 24,25 For HPV1 OPSCC specifically, the features of irregular nodal margins and the absence of perinodal fat plane on CT scans used to assess cENE designation were found to have PPVs of 80% to 82% and NPVs of 64% to 73%.…”

Diagnostic role of ultrasound elastography on lymph node metastases in patients with head and neck cancer

“…True detectability rate (accuracy rate) of neck metastasis by palpation has been reported around 70%. 8 , 9 , 10 , 11 In our study, the sensitivity, specificity and accuracy rates of palpation were 47%, 92% and 66.7% respectively. These values are certainly quite insufficient to make accurate assessments.…”