Comparison of CT and MR imaging in staging of neck metastases.

Curtin, Hugh D.; Ishwaran, Hemant; Mancuso, Anthony A.; Dalley, Robert W.; Caudry, Daryl J.; McNeil, Barbara J.

doi:10.1148/radiology.207.1.9530307

Cited by 351 publications

(171 citation statements)

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“…Therefore, we used the 1-cm size to indicate a positive node. The positive predictive value of this criterion was only 50% in the study of Curtin et al (1998). This low value might explain our good results in cases with M1 LYM disease, although all 15 patients with M1 LYM disease had advanced T3 or T4 disease with severe stricture.…”

Section: Discussionmentioning

confidence: 72%

“…Furthermore, we modified the criteria described previously for the definition of T3 disease (Picus et al, 1983) to include tumours attached to the organs at a p901 angle to the thoracic aorta as observed on the CT scan. The patients were considered to have LYM if the tumour was X1 cm in diameter (Curtin et al, 1998). Radiological evaluations for staging were reviewed by two radiologists (TK and YM) and the physicians at Showa University School of Medicine, as was reported in previous studies (Picus et al, 1983;Takashima et al, 1991;Curtin et al, 1998).…”

Section: Eligibility Criteriamentioning

confidence: 99%

“…The patients were considered to have LYM if the tumour was X1 cm in diameter (Curtin et al, 1998). Radiological evaluations for staging were reviewed by two radiologists (TK and YM) and the physicians at Showa University School of Medicine, as was reported in previous studies (Picus et al, 1983;Takashima et al, 1991;Curtin et al, 1998). However, while the UICC staging criteria were adopted in these previous studies, we used a non-standard staging technique in this study, especially when evaluating the depth of tumour infiltration.…”

Section: Eligibility Criteriamentioning

confidence: 99%

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Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

et al. 2003

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We retrospectively investigated the efficacy and feasibility of concurrent chemoradiotherapy for patients with severe dysphagia caused by oesophageal squamous cell carcinoma. Concurrent chemoradiotherapy was performed in 57 patients with T3 or T4 disease containing M1 lymph node (LYM) disease. Chemotherapy consisted of protracted infusion of 5-fluorouracil (5-FU) 400 mg m À2 24 h À1 on days 1 -5 and 8 -12, combined with 2-h infusion of cisplatin (CDDP) 40 mg m À2 on days 1 and 8. Radiation treatment at a dose of 30 Gy in 15 fractions of the mediastinum was administered concomitantly with chemotherapy. A course schedule with 3-week treatment and a 1 to 2-week break was applied twice, with a total radiation dose of 60 Gy, followed by two or more courses of 5-FU and CDDP. In all, 24 patients (42%) achieved a complete response, and the 3-year survival rate was 19%. Major toxicities were leukocytopenia and oesophagitis, and there were two (4%) treatment-related deaths. In contrast, 22 patients with T3 disease survived longer than 35 patients with T4 disease (P ¼ 0.001); however, the survival rate in 15 patients with M1 LYM disease did not differ significantly from that in 42 patients without M1 LYM disease (P ¼ 0.3545). Our results indicate that definitive chemoradiotherapy is potentially curative for locally advanced oesophageal carcinoma with malignant stricture. The efficacy and survival of patients treated with this regimen are related to the T factor.

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Section: Discussionmentioning

confidence: 72%

Section: Eligibility Criteriamentioning

confidence: 99%

Section: Eligibility Criteriamentioning

confidence: 99%

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Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

et al. 2003

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“…Frequently used criteria for differentiation between benign and malignant lymph nodes are the presence of necrosis-mainly seen in larger lymph nodes-and assessment of lymph node morphology such as borders and internal heterogeneity [9,10]. Also the introduction of lymph node specific contrast agents like ultrasmall particles iron oxide on magnetic resonance imaging (MRI) provides differentiation between benign and malignant lymph nodes in the head and neck and results are improving [11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy and additional value of diffusion-weighted imaging for discrimination of malignant cervical lymph nodes in head and neck squamous cell carcinoma

et al. 2009

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Introduction The aim was to determine the diagnostic accuracy and additional value of diffusion-weighted imaging for detection of malignant lymph nodes in head and neck squamous cell carcinoma.Methods Two hundred nineteen lymph nodes, predominantly smaller than 10 mm (95.4%), in 16 consecutive patients were evaluated at 1.5 T. Lymph nodes were evaluated for maximum short axial diameter, morphological criteria, and apparent diffusion coefficient (ADC) values (b=0 and b=1,000 s/mm 2 ). Sensitivity, specificity, positive and negative predictive values as well as diagnostic odds ratios (DORs) and areas under the curves (AUCs) of ROC curves were calculated for the various magnetic resonance imaging (MRI) criteria individually and in combination. Histological examination of lymph nodes in the neck dissection specimen was the gold standard to determine malignant involvement. Results The optimal ADC threshold was 1.0×10 −3 mm 2 /s. Using this cutoff point, sensitivity and specificity were 92.3% and 83.9%, respectively. When used in combination with size and morphological criteria, ADC value <1.0× 10 −3 mm 2 /s was the strongest predictor of presence of metastasis (DOR=97.6). A model which added ADC values to the other MRI criteria performed significantly better than a model without ADC values: AUC=0.98 versus AUC=0.91 (p=0.036). Conclusion In this study, with predominantly small lymph nodes, the ADC criterion is the strongest independent predictor of presence of metastasis. The use of ADC values in combination with the other MRI criteria significantly improves the discrimination between malignant and benign lymph nodes.

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“…This study indicated that END significantly improved lymph node 27 , and it occurs primarily in lymph nodes approximating 20.0 mm or greater 28 . It is also quite rare and not often visible in small lymph nodes 29,30 . The generally used upper limit of normal for the greatest nodal diameter is 1.5 cm for level I and II nodes, and 1 cm for all other levels.…”

Section: Discussionmentioning

confidence: 99%

Initial CT findings in early tongue and oral floor cancer as predictors of late neck metastasis

Furusawa¹,

Suzuki²,

Homma³

et al. 2008

Oral Oncology

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Comparison of CT and MR imaging in staging of neck metastases.

Abstract: CT performed slightly better than MR imaging for all interpretative criteria. However, a high NPV was achieved only when a low size criterion was used and was therefore associated with a relatively low PPV.

Cited by 351 publications

References 0 publications

Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

Diagnostic accuracy and additional value of diffusion-weighted imaging for discrimination of malignant cervical lymph nodes in head and neck squamous cell carcinoma

Initial CT findings in early tongue and oral floor cancer as predictors of late neck metastasis

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