Occult metastatic neck disease: detection with US and US-guided fine-needle aspiration cytology.

Abstract

The authors performed a prospective study of the value of ultrasonography (US) and US-guided fine-needle aspiration cytology (FNAC) for assessment of N0 lesions in the neck. Preoperative US was performed in 107 patients with squamous cell carcinoma of the head and neck, who underwent 132 elective neck dissections. During the US examination of the last 54 patients, who underwent 70 elective neck dissections, US-guided FNAC was performed. US alone was found to be an unreliable method for detecting occult lymph node metastasis; the accuracy never exceeded 70% (93 of 132), with a sensitivity of 60% (32 of 53) and a specificity of 77% (61 of 79). In contrast, US-guided FNAC had an accuracy of 89% (62 of 70), a sensitivity of 76% (25 of 33), and a specificity of 100% (37 of 37). Because of the high sensitivity and specificity of US-guided FNAC for the assessment of the N0 neck, this modality may play an important role in directing treatment of these patients in the future.

Detection of Cervical Lymphnode Metastasis in Oral Squamous Cell Carcinoma by Ultrasonogram Guided Fine Needle Aspiration Cytology (FNAC) and Comparison with Computed Tomographic (CT) Findings

“…In the analysis accuracy was found 91.9%, which translates into ability of FNAC test to provide correct diagnosis in 92 % occasions (table-IIc). FNA of the neck has been well tolerated by patients in previous studies 6,20,21 and, similar to our experience, no serious complications have occurred. Ultrasound, FNAC also has the potential advantage of being less costly than CT.…”

The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma

“…22 However, the criteria vary between imaging modalities; and, even within a given modality, the size criteria constantly are being refined. [23][24][25] Reducing the size criteria would increase sensitivity for the detection of malignant LNs but would increase the number of reactive LNs identified in the study, even identifying some normal LNs as malignant. 26 18 F-fluorodeoxyglucose (FDG)-PET is a very useful technique for the detection of distant metastases, but little discrepancy was observed in neck LN staging between MRI and FDG-PET findings.…”

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

“…Another commonly used criterion is the maximum short axial diameter for which several studies have been undertaken to determine the optimal cutoff size [17,18]. Small lymph nodes with a maximum short axial diameter below 10 mm are more challenging for radiologists, because the mere use of this size criterion will result in misclassification of malignant lymph nodes as normal on MRI evaluation.…”