Cervical lymphadenopathy: ratio of long- to short-axis diameter as a predictor of malignancy

Abstract

The purpose of this study was to evaluate short- and long-axis diameters of enlarged cervical lymph nodes with ultrasonography and to determine whether the long-to-short axis (l/s) ratio is a valid diagnostic parameter in the differentiation between benign and malignant nodal disease. 730 enlarged cervical lymph nodes in 285 patients were examined with ultrasound. The short- and the long-axis diameters of each enlarged node were measured and the l/s ratio calculated. Definite diagnoses of the nodes were obtained by histological examination following neck dissection. 95% of enlarged cervical nodes shown on ultrasound to have a l/s ratio of more than 2 were correctly diagnosed as benign. Nodes presenting with a more circular shape and a l/s ratio of less than 2 were diagnosed correctly as metastases with 95% accuracy. The l/s ratio of lymph nodes thus provides an excellent criterion for differentiation between benign and malignant enlargement in cervical lymphadenopathy.

Assessment of Cervical Lymph Nodes in Squamous Cell Carcinoma of the Head and Neck

“…They noted the decrease of false positive results from 63% to 5% using the L/S ratio. Sarvanan et al [17] have showed similar sensitivity (94.44%) and higher specificity (100%) than that reported by Steinkamp et al [18].…”

“…A sensitivity of 82.9% and a specificity of 89.66% for CT scanning and a sensitivity of 97.1% and a specificity of 93% for ultrasound scanning. Steinkamp et al [18] reported 95% sensitivity of the L/S ratio as well as a specificity of 95% compared with 37% for the long axis method and 86% for the transverse diameter method. They noted the decrease of false positive results from 63% to 5% using the L/S ratio.…”

“…We followed the ratio of long to short axis diameters (L/S) or (L/T) as proposed by Steinkamp et al [18]. This ratio assesses the shape of the lymph node.…”

Ultrasound examination of regional lymph nodes significantly improves early detection of locoregional metastases during the follow-up of patients with cutaneous melanoma

“…In the follow-up of patients with breast carcinoma and patients with head and neck tumors, ultrasound of the regional lymph nodes is of great importance because early detection of lymph node disease also influences the prognosis of these malignancies. 16,17 Computer tomography of the lymph nodes has been shown to be less adequate, because the examination is performed in one transverse section only. 18 Early detection of subcutaneous and regional metastases in patients with cutaneous melanoma seems to be critical for the prognosis.…”

USPIO‐enhanced magnetic resonance imaging for nodal staging in patients with head and neck cancer

“…Using these imaging modalities, the criteria for diagnosing metastatic nodes is mainly dimensional. Measurements include the minimum transaxial diameter, the maximum transaxial diameter or a ratio between the maximum longitudinal and the maximum axial diameters (3)(4)(5)(6)(7). Other parameters, such as morphological criteria or the pattern of enhancement, are regarded as less important in this setting.…”