Can extranodal spread in head and neck cancer be detected on MR imaging

Abstract

The MRI finding "infiltration of adjacent planes" may be high enough (100% in our study) to be used for treatment planning.

Radiologic extranodal spread and matted nodes: Important predictive factors for development of distant metastases in patients with high‐risk head and neck cancer

“…In the present study, the criteria used for declaring ENS were capsular contour irregularity and infiltration of adjacent planes. Lodder et al reported for these single criteria, using histopathological examination as reference standard, a sensitivity of 63% and 50% and a specificity of 93% and 100%, respectively. They found also that the largest diameter of >20 mm or >30 mm predicted ENS with a sensitivity of 70% and 50% and a specificity of 70% and 80%, respectively .…”

“…Lodder et al reported for these single criteria, using histopathological examination as reference standard, a sensitivity of 63% and 50% and a specificity of 93% and 100%, respectively. They found also that the largest diameter of >20 mm or >30 mm predicted ENS with a sensitivity of 70% and 50% and a specificity of 70% and 80%, respectively . We found a significant association between the presence of ENS on CT and/or MRI as a risk factor and the clinical risk factor of a lymph node of 6 cm or larger.…”

“…These characteristics include: capsular contour irregularity and/or infiltration of adjacent lanes; presence of noncontrast‐enhancing parts inside a lymph node; irregular contrast enhancement; and central nodal necrosis. Using one or more of these characteristics, sensitivity of 60% to 95% and specificity of 72% to 100% have been reported . However, because consensus among pathologist on the detection of ENS by histopathological examination (the current gold standard) is not satisfactory, the value of these accuracy data is debatable.…”

Unknown primary head and neck squamous cell carcinoma in the era of fluorodeoxyglucose‐positron emission tomography/CT and intensity‐modulated radiotherapy

“…Extracapsular extension (ECE) was being evaluated on imaging, in case of doubt, a (super)selective neck dissection was done to confirm or exclude ECE.…”

Lymph Node Disease and Advanced Head and Neck Imaging: A Review of the 2013 Literature

“…Lodder et al [36] retrospectively studied the ability of MRI to detect ECS in 39 patients who had HNSCC that had been evaluated pre-operatively and subsequently underwent neck dissection. Using nodal measurements in conjunction with radiological and surgical designated neck nodal levels, a retrospective topographical correlation was performed.…”