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RESEARCH PRODUCT

[Use of imaging criteria to identify cervical metastases using CT scans in head and neck tumours].

subject

description

Abstract Objective To assess the diagnostic certainty of CT images to identify regional spread of head and neck tumours. Patients and method A CT study was performed on 86 patients with neoplasms in the larynx and/or pharynx. After this, surgical dissection was performed for 142 neck sides. In the imaging study the following parameters were considered for all patients before suspecting malignant nodes: size of adenopathy bigger than 10–11 mm, irregular borders, central necrosis, spherical shape, capsular enhancement, and presence of groups with 3 or more lymphadenopathies. Results 48.5% of dissections were N+. Sensitivity and specificity for physical examination were 59% and 82%, respectively, against 73% and 86% for CT. Lymph node necrosis was the pattern with the greatest sensitivity and specificity (35.8% and 100%, respectively) and its accuracy was 69.7%. Accuracy was 60.5% for spherical shape, 59.8% for node size, and between 54% and 58% for the other 3 criteria. In the histopathological findings, 25% of neck dissections were N+ when only one pattern had been detected on CT, whereas those neck sides in which 4 patterns were identified simultaneously showed regional spread in 100%. Conclusions The presence of specific morphological imaging criteria for head and neck tumours in cervical lymph nodes and their concomitance increase the accuracy of imaging to predict regional spread.