Kapseldurchbrüche zervikaler Lymphknotenmetastasen: Diagnostischer Stellenwert der Magnetresonanztomographie

Hj, Steinkamp; Beck, Andreas; Werk, Michael; Félix, R.

doi:10.1055/s-2002-19533

Cited by 44 publications

(7 citation statements)

References 9 publications

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“…Moreover, MRI has a poor ability to detect ECS objectively; radiologic–pathologic studies reported a sensitivity of 74% to 80%, specificity of 72% to 78%, and accuracy of 76% to 86% for MRI. 29 , 30 Multivariate analysis showed that ECS failed to show any independent prognostic value after stratification by nodal level, age, sex, T classification, chemotherapy, and necrosis, and was excluded from the proposed N category, in agreement with the study by Li et al 11 …”

Section: Discussionsupporting

confidence: 76%

Suggestions for Lymph Node Classification of UICC/AJCC Staging System

et al. 2015

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This article provides suggestions for N classification of Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system of nasopharyngeal carcinoma (NPC), purely based on magnetic resonance imaging (MRI) in intensity-modulated radiation therapy (IMRT) era.A total of 1197 nonmetastatic NPC patients treated with IMRT were enrolled, and all were scanned by MRI at nasopharynx and neck before treatment. MRI-based nodal variables including level, laterality, maximal axial diameter (MAD), extracapsular spread (ECS), and necrosis were analyzed as potential prognostic factors. Modifications of N classification were then proposed and verified.Only nodal level and laterality were considered to be significant variables affecting the treatment outcome. N classification was thus proposed accordingly: N0, no regional lymph node (LN) metastasis; N1, retropharyngeal LNs involvement (regardless of laterality), and/or unilateral levels I, II, III, and/or Va involvement; N2, bilateral levels I, II, III, and/or Va involvement; and N3, levels IV, Vb, and Vc involvement. This proposal showed significant predicting value in multivariate analysis. N3 patients indicated relatively inferior overall survival (OS) and distant metastasis-free survival (DMFS) than N2 patients; however, the difference showed no statistical significance (P = 0.673 and 0.265 for OS and DMFS, respectively), and this was considered to be correlated with the small sample sizes of N3 patients (79 patients, 6.6%).Nodal level and laterality, but not MAD, ECS, and necrosis, were considered to be significant predicting factors for NPC. The proposed N classification was proved to be powerfully predictive in our cohort; however, treatment outcome of the proposed N2 and N3 patients could not differ significantly from each other. This insignificance may be because of the small sample sizes of N3 patients. Our results are based on a single-center data, to develop a new N classification that is universally acceptable; further verification by data from multicenter is warranted.

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Section: Discussionsupporting

confidence: 76%

Suggestions for Lymph Node Classification of UICC/AJCC Staging System

et al. 2015

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“…Generally speaking, however, the limited sensitivity and specificity of the methods used in relation to the clinical diagnosis of ENE need to be discussed (8). For example, Steinkamp et al showed in several publications a sensitivity of ∼80.9% with specificity of 72.2% for CT investigations and sensitivity of ∼74.4% and specificity of 72.2% for MRI imaging (1,12,13). Clinical diagnosis of ENE by ultrasound, with a sensitivity of 78.6% and specificity of 81.8%, achieved slightly better results than CT or MRI (1,14).…”

Section: Imaging and Clinical Predictors In Diagnosing Extranodal Extmentioning

confidence: 99%

Significance of Extranodal Extension in Surgically Treated HPV-Positive Oropharyngeal Carcinomas

et al. 2020

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“…The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 43.7%, 97.7%, 82.6%, 87.3%, and 86.8%, respectively. Steinkamp et al (15) evaluated diagnostic performance of MRI for ENE in 110 patients with HNSCC. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 74.4%, 72.2%, 76.1%, 70.3%, and 73.4%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of FDG-PET/CT for the Identification of Extranodal Extension in Patients With Head and Neck Squamous Cell Carcinoma

et al. 2020

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Background/Aim: We evaluated the diagnostic value of functional imaging with [ 18 F]-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography/computed tomography (PET/CT) for the identification of extranodal extension (ENE) in patients with head and neck squamous cell carcinoma (HNSCC). Patients and Methods: In this study, 94 patients with HNSCC who underwent FDG-PET/CT were enrolled. We recorded the maximum standardized uptake value (SUV max), compared the results with pathologic findings, and evaluated the diagnostic performance of using a SUV max cutoff value for ENE. Results: Of the 566 dissected levels examined, 53 (9.4%) exhibited ENE. The mean SUV max of LN with and without ENE were 6.67 and 1.64, respectively (p<0.001). A receiver operating characteristics (ROC) curve analysis for SUV max showed an area under the ROC curve of 0.913. A SUV max cutoff of 3.0 achieved diagnostic performance for identifying ENE with sensitivity, specificity, and accuracy of 81.1%, 94.3% and 93.1%, respectively. Conclusion: FDG-PET/CT findings using a SUV max cutoff of 3.0 provides appropriate diagnostic value in identifying ENE.

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Kapseldurchbrüche zervikaler Lymphknotenmetastasen: Diagnostischer Stellenwert der Magnetresonanztomographie

Abstract: The specificity (72.2 %) and sensitivity (74.4 %) of MRI examinations to detect extracapsular spread of lymph nodes is only partially satisfying.

Cited by 44 publications

References 9 publications

Suggestions for Lymph Node Classification of UICC/AJCC Staging System

Suggestions for Lymph Node Classification of UICC/AJCC Staging System

Significance of Extranodal Extension in Surgically Treated HPV-Positive Oropharyngeal Carcinomas

Diagnostic Value of FDG-PET/CT for the Identification of Extranodal Extension in Patients With Head and Neck Squamous Cell Carcinoma

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