Imaging of lymphadenopathy in the neck

Castelijns, Jonas A.; Brekel, M.W.M. van den

doi:10.1007/s003300101102

Cited by 158 publications

(86 citation statements)

References 83 publications

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“…Between 40% and 60% of all occult metastases are found using either CT or MRI at the cost of a relatively high rate of false positives. 6 In contrast, USgFNAC has a higher sensitivity and specificity and is more cost-effective than CT and MRI. In experienced hands, the sensitivity for the N0 neck can reach 73% with a specificity of 100%, 7 although others reported sensitivities ranging from 42% to 50%.…”

Section: Introductionmentioning

confidence: 99%

FDG PET in oral and oropharyngeal cancer. Value for confirmation of N0 neck and detection of occult metastases

et al. 2008

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FDG PET in oral and oropharyngeal cancer. Value for confirmation of N0 neck and detection of occult metastases Krabbe, Christiaan A.; Dijkstra, Pieter U. ; Pruim, Jan; van der Laan, Bernard F.A.M.; van der Wal, Jacqueline E.; Gravendeel, Joost P.; Roodenburg, Johannes Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Summary Treatment of the clinical N0 neck in squamous cell carcinoma (SCC) of oral cavity and oropharynx remains a dilemma. None of the current imaging modalities are able to detect the presence of micrometastases in the lymph nodes of clinical N0 necks reliably. The aim of this study was to determine the diagnostic properties of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) in patients clinically staged as N0. FDG PET results of 38 patients were compared to histologic specimens obtained with neck dissections or to follow-up. FDG PET performance was compared to computed tomography (CT), magnetic resonance imaging (MRI) or ultrasonography-guided fine needle aspiration cytology (USgFNAC). Sensitivity and specificity of FDG PET in detecting occult cervical metastases were 50% and 97% respectively. Although FDG PET performed better than conventional imaging modalities, sensitivity was lower than desired. As a consequence, clinical application of FDG PET in the patient staged as N0 is limited.

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Section: Introductionmentioning

confidence: 99%

FDG PET in oral and oropharyngeal cancer. Value for confirmation of N0 neck and detection of occult metastases

et al. 2008

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“…Thus, neck dissection with subsequent pathological examination remains the criterion standard for node staging. [37][38][39] Diagnostic performance of imaging studies are difficult to compare owing to a variety in study designs, study populations, imaging modalities and techniques. 29,36 In conclusion, the study has found differences between the N-stage performed by OMRs and MRs.…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced CT and MRI for detecting neck metastasis of oral cancer: comparison between analyses performed by oral and medical radiologists

Figueiredo

Leite²,

Barra³

et al. 2012

Dentomaxillofacial Radiology

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Objectives: The aim of the study was to verify the concordance of contrast-enhanced CT (CECT) and MRI evaluation among four radiologists in detecting metastatic cervical lymph nodes of oral cancer patients. Methods: Ten patients underwent clinical and imaging examinations (CECT and MRI). Four radiologists, two oral and maxillofacial radiologists (OMRs) and two medical radiologists (MRs), independently analysed the images twice. Cohen's kappa index and Wilcoxon signed-rank test were used to verify the concordance between all analyses. Results: Regarding the interobserver agreement, the OMRs presented excellent kappa values for determining the regional lymph nodes (N-stage) in both CECT and MRI. The MRs presented moderate agreement for CECT evaluation at the first reading, but no concordance was found for the other analyses. When each imaging modality was analysed separately, kappa values were higher between all examiners. Greater variability was demonstrated between Nstage evaluation using different examinations. All radiologists were able to identify a greater number of metastatic lymph nodes in CECT than in MRI, except one MR, but no significant difference was found for all readers. The differences between the number of metastatic lymph nodes among all radiologists were not statistically significant. Moderate intraobserver agreement was observed for CECT and MRI evaluation, except for one MR. Conclusions: The differences found between the N-stage performed by OMRs and MRs support the necessity of a multidisciplinary approach in the imaging evaluation of metastatic nodes. Further studies are necessary to confirm which imaging modality should be employed when evaluating neck areas.

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“…26 Finally, US has the unique advantage of real-time pathologic correlation via US-guided FNAC, which can be instantly analyzed and, if necessary, repeated and confirmed with multiple passes within the timeframe of a single study. 27 For reasons of cost and efficiency, US generally has been used more liberally in Europe than in the United States 28,29 and has been proposed as a follow-up strategy for the neck in some international forums. 30,31 Specifically in the postradiation setting, one older study established that the effects of preoperative irradiation could be identified by using morphologic changes visualized on US.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Examination of the Neck after Definitive Radiotherapy for Node-Positive Oropharyngeal Cancer

Yom¹,

Garden²,

Staerkel³

et al. 2011

AJNR Am J Neuroradiol

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Imaging of lymphadenopathy in the neck

Cited by 158 publications

References 83 publications

FDG PET in oral and oropharyngeal cancer. Value for confirmation of N0 neck and detection of occult metastases

FDG PET in oral and oropharyngeal cancer. Value for confirmation of N0 neck and detection of occult metastases

Contrast-enhanced CT and MRI for detecting neck metastasis of oral cancer: comparison between analyses performed by oral and medical radiologists

Sonographic Examination of the Neck after Definitive Radiotherapy for Node-Positive Oropharyngeal Cancer

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