Screening for lymph nodes in the neck with ultrasound

Jong, Robert J. Baatenburg de; Rongen, R. J.; Jong, P. C. De; Lamerisy, J. S.; Knegt, P.

doi:10.1111/j.1365-2273.1988.tb00274.x

Cited by 37 publications

(2 citation statements)

References 3 publications

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“…The accuracy of 65.38% for palpation in our study is comparable to other studies. [ 14 15 16 17 ] Due to the low sensitivity of clinical palpation, one option would be to look for more reliable methods to assess the neck one of which would be ultrasonography. Sajeeda et al .…”

Section: Discussionmentioning

confidence: 99%

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A clinical, radiological, and histopathological correlation of neck nodes in patients undergoing neck dissection

Mehta

Sharma

Madhok

et al. 2018

Int J App Basic Med Res

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Objectives:Management of neck metastases in terms of diagnosis and treatment has always been a controversial issue in patients of head and neck malignancy. The main area of debate in case of diagnosis lies with the fact that whether we should rely on ultrasound, as a diagnostic modality for diagnosing micrometastases in the neck in head and neck malignancy patients? The second controversial issue is the management of N0 neck, whether to be radical or conservative?Materials and Methods:This study was conducted on 70 diagnosed patients of head and neck carcinoma who were planned for resection of the primary. An appropriate neck dissection was performed in all the patients, and their clinical, ultrasonography, and postoperative histopathological neck findings were correlated.Results:In our center, the most common site of the primary tumor was oral cavity with most involving buccal mucosa. As expected, T4 lesions were commonly associated with nodal metastasis (71%). The sensitivity of clinical examination and ultrasound was 80% and 93.3%, respectively, and specificity of clinical examination and ultrasound was 57% and 27.2%, respectively. Histopathologically positive but clinically nonpalpable metastases in the study group were more frequent in levels Ib, II, and III, respectively.Conclusion:We concluded that ultrasonography being a low cost and a highly sensitive investigation can act in tandem with clinical examination for diagnosing the neck for metastases preoperatively in head and neck malignancy patients. However, due to its low specificity, we cannot completely rely on it, hence doing a neck dissection in selective form, will definitely improve the clinical course of the disease in N0 necks.

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Section: Discussionmentioning

confidence: 99%

“…[ 19 ] The accuracy of ultrasound in our study can be compared to previous studies conducted where they got the accuracy of 70%, 72.7%, and 72.2%, respectively. [ 14 15 20 ]…”

Section: Discussionmentioning

confidence: 99%

A clinical, radiological, and histopathological correlation of neck nodes in patients undergoing neck dissection

Mehta

Sharma

Madhok

et al. 2018

Int J App Basic Med Res

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Metastatic Neck Disease: Palpation vs Ultrasound Examination

Jong

Rongen²,

Laméris³

et al. 1989

Archives of Otolaryngology - Head and Neck Surgery

147

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\s=b\Nodal disease is a diagnostic problem in head and neck oncology. Current methods for investigation of the neck are not satisfactory as far as differentiation between necks with positive nodes and those with negative nodes is concerned. In the present study, the results of palpation and ultrasound examination were compared with histopathologic examination results of 120 neck dissection specimens. Furthermore, the value of ultrasound examination, combined with cytologic examination, of neck nodes was evaluated. Ultrasound examination was characterized by high sensitivity, ie, 96.8%; specificity was 32.0%. When the results of ultrasound-guided fine-needle aspiration biopsy were added to the ultrasound findings, specificity was as high as 92.9%. From these results, it was concluded that ultrasound examination with fine-needle aspiration biopsy is an accurate method for assessment of the neck in head and neck oncology. (Arch Otolaryngol Head Neck Surg 1989;115:689-690) Treatment and prognosis of pa¬ tients with head and neck malig¬ nant neoplasms are mainly deter¬ mined by nodal disease. Differentia¬ tion between necks with positive nodes and those with negative nodes, however, is still a diagnostic problem in head and neck oncology. Current methods for investigation of the neck are not satisfactory, as both palpation and computed tomography (CT) are characterized by high false-negative and false-positive rates.Reviewing relevant literature, it can be stated that palpation has a false-positive rate between 15% and 65% (most authors mention 25%) and a false-negative rate between 10% and 15% .M In a recent article by Feinmesser et al,5 the false-positive rate of CT was 18.4%, and the false-negative rate was 34%. In this study, no signif¬ icant differences in the false-positive and false-negative rates were demon¬ strated for palpation and CT.Low specificity and other draw¬ backs of CT (the need for using intra¬ venous contrast, radiation exposure, and high costs) have led us to test ultrasound examination as an alter¬ native imaging modality for investi¬ gation of the neck. Results of a pilot study were recently published.6 The present study was undertaken to com¬ pare palpation, ultrasound, and histo¬ pathologic findings. Furthermore, the value of fine-needle aspiration biopsy for cytologie study of neck nodes, in combination with ultrasound exami¬ nation, is evaluated. PATIENTS AND METHODSBetween December 1984 and April 1988, 100 patients with head and neck cancer were, before neck dissection, examined by palpation of the neck and ultrasound. With few exceptions, the malignant neoplasms were squamous cell carcinomas. Sixty-two necks were treated by radiotherapy before they entered the study. All patients were examined by one of the members of the oncologie staff (P.K.). Size and localization of palpable nodes were documented.Subsequently, patients were referred to the radiology department. Small-parts transducers of 5 or 7.5 MHz (Ana, Calif) were used for the ultrasound examination. The radiologist (R.J.R.) p...

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