CT of cervical lymph node cancer

Mancuso, A A; Maceri, Dennis R.; Rice, Dale H.; Hanafee, W. N.

doi:10.2214/ajr.136.2.381

Cited by 144 publications

(57 citation statements)

References 7 publications

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“…The CT scan can differentiate a single enlarged lymph node from a conglomerate of matted lymph nodes and it can identify central lymph node necrosis. 21 Close et al 22 found that the CT scan upstaged the clinically negative neck in 67% of cases of oral cavity and oropharyngeal carcinoma and several studies have shown a greater than 90% accuracy rate for CT scanning of pathologic neck disease. [17][18][19] In the current study, imaging had an 84% sensitivity rate in detecting pathologic lymph node disease in cN-positive patients.…”

Section: Discussionmentioning

confidence: 99%

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Greenberg

Naggar

et al. 2003

Cancer

167

116

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At present, storage capacities of single tank and tank farm have been greatly increasing. This change poses a real challenge for the applicability of current design standards. This article focuses on the applicability of safety spacing between tanks, which is one of the most important parameters of tank farm safety design. Taking PHAST and FDS as main research tools, the consequences of representative accidental scenarios were evaluated for different sizes of oil tanks to study the safety performance change caused by the increase of capability. The research results show that, when current standards are used to design the safety spacing between tanks, the safety performance increases as the capability increases. Considering the high property density, it is suggested that a higher safety performance objective has to be chosen when designing the safety spacing for ultra‐large oil tanks. © 2012 American Institute of Chemical Engineers Process Saf Prog, 2012.

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Section: Discussionmentioning

confidence: 99%

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Greenberg

Naggar

et al. 2003

Cancer

167

116

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“…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.…”

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confidence: 99%

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

Curvo-Semedo

Diniz

Miguéis

et al. 2006

Magnetic Resonance Imaging

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Purpose:To determine the accuracy of ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI) for nodal staging in patients with head and neck cancer. Materials and Methods:Twenty patients with carcinomas of the upper aerodigestive tract were prospectively enrolled. MRI was performed before and 24 -36 hours after intravenous infusion of an USPIO agent, ferumoxtran-10 (Sinerem; Guerbet, France; and Combidex; Advanced Magnetics) at a dose of 2.6 mg Fe/kg using T2-weighted spin-echo and gradient-echo sequences. Surgery was performed the same day or the day after the ferumoxtran-10 -enhanced MR examination. Based on MRI, selected nodes were surgically removed and directly correlated with pathology using hematoxylin-eosin (H&E) and Perls stainings.Results: A total of 63 nodes were studied; 36 were nonmetastatic, 25 metastatic, and two inflammatory. Ferumoxtran-10 -enhanced MRI allowed diagnosis of 24 metastatic and 30 nonmetastatic nodes, yielding a sensitivity of 96%, a specificity of 78.9%, a positive predictive value of 75%, and a negative predictive value of 96.8%, compared to 64%, 78.9%, 66.6%, and 76.9%, respectively, for nonenhanced MRI. Accuracy of ferumoxtran-10 -enhanced MRI was 85.7%. The gradient-echo T2-weighted sequence was the most accurate to detect signal loss in nonmetastatic nodes.Conclusion: USPIO-enhanced MRI is useful for nodal staging of patients with head and neck cancers. CROSS-SECTIONAL IMAGING plays an important role in the study of patients with head and neck squamous cell carcinomas, allowing detection of lymph nodes (LN) missed by physical examination, or demonstrating invasion of structures such as the skull base or the carotid arteries (1,2). 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 (3-7). Other parameters, such as morphological criteria or the pattern of enhancement, are regarded as less important in this setting. Nodal metastases in the head and neck are frequently smaller than 10 mm, sometimes even under 5 mm in diameter, a fact that accounts for the unsatisfactory performance of the current imaging techniques (8,9).MRI can be improved when using contrast agents suited for intravenous MR lymphography, such as the new ultrasmall superparamagnetic iron oxide (USPIO) particles, which are taken up by cells of the reticuloendothelial system of nonmetastatic LN (10 -15). As it has been shown in previous studies, iron oxide deposition leads to a decrease in the signal intensity (SI) in nonmetastatic nodes due to the T2 shortening effects, whereas metastatic nodes, devoid of macrophages, will not undergo SI changes when using T2-weighted sequences (11). The clinical use of this contrast agent is still under evaluation on phase III clinical trials (15)(16)(17)(18)(19)(20). Reports show promising results, with sensitivity and specificity value...

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“…Second, meta· static nodes showed a more rounded configuration than A precise evaluation of the presence of meta· stasis to the cervical lymph nodes is mandatory in the management of head and neck malignancies. X-ray computed tomography (CT), 1 magnetic resonance imaging (MRI), and ultrasound 2 -4 have been used to evaluate lymphadenopathy in the neck. Recent reports on ultrasonography in the neck suggest its high efficiency in detecting small, nonpalpable lymphadenopathy.…”

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confidence: 99%

Ultrasonic evaluation of cervical metastatic lymphadenopathy.

Sakai

Kiyono

Sone

et al. 1988

Journal of Ultrasound in Medicine

114

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We investigated the location, size, and shape of cervical lymph nodes in head and neck cancer, using a 7.5-MHz ultrasound scanner. First, the different criteria for normal size were obtained for cervical lymph nodes in each region; lymph nodes greater than 9 mm in thickness in the internal jugular chain or greater than 7 mm in thickness in the submandibular and submental chains should be suspected of harboring metastatic foci. Second, meta· static nodes showed a more rounded configuration than A precise evaluation of the presence of meta· stasis to the cervical lymph nodes is mandatory in the management of head and neck malignancies. X-ray computed tomography (CT), 1 magnetic resonance imaging (MRI), and ultrasound 2 -4 have been used to evaluate lymphadenopathy in the neck. Recent reports on ultrasonography in the neck suggest its high efficiency in detecting small, nonpalpable lymphadenopathy. Although size has been used to diagnose me~ tastasis in lymph nodes, few studies have dealt with their internal structure.To determine the size and shape criteria for normal lymph nodes in each region in the neck, as well as to clarify any abnormal patterns of internal structure in metastatic lymph nodes, we conducted a correlative Received July 20, 1987, from the Departments of "Radiology, fOral Surgery. *Otolaryngology. and §Laboratory Medicine, School of Medi· cine, Shinshu University. Asahi, Matsumoto, Japan. Revised manuscript accepted for publication October 29, 1987. Address correspondence and reprint requests to Dr. F. Sakai: De· partment of Radiology, School of Medicine, Shinshu University, Asahi, Matsumoto, 390, Japan. nonmetastatic ones. Third, a comparative study of metastatic lymph nodes between the in vivo and in vitro ultrasonograms and the corresponding histopathological findings disclosed that an echogenic region in an ultrasonogram of a metastatic node was caused by coagulation necrosis, and a cystic area of liquefaction necrosis. KEY WORDS; ultrasonography, lymphadenopathy, echogenicity, size of lymph node. (/ Ultrasound Med 7: 305, 1988)

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CT of cervical lymph node cancer

Abstract: Ten patients with carcinoma of the base of the tongue, larynx, and hypopharynx who had radical neck dissection form this group (table 2). For gross pathologic correlation,

Cited by 144 publications

References 7 publications

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

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

Ultrasonic evaluation of cervical metastatic lymphadenopathy.

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