Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-23T09:07:15.612Z Has data issue: false hasContentIssue false

Echography of metastatic nodes treated by radiotherapy

Published online by Cambridge University Press:  29 June 2007

A. Ahuja*
Affiliation:
Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, NT, Hong Kong.
S. F. Leung
Affiliation:
Department of Clinical Oncology, Prince of Wales Hospital, Shatin, NT, Hong Kong.
M. Ying
Affiliation:
Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, NT, Hong Kong.
C. Metreweli
Affiliation:
Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, NT, Hong Kong.
*
Address for correspondence: Dr Anil T. Ahuja, Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, NT, Hong Kong. Fax: (852) 636 0012

Abstract

The purpose of this study was to evaluate whether the ultrasonographic appearances of nodal metastases in nasopharyngeal carcinoma (NPC) revert to normal after radiotherapy.

Serial ultrasonography was performed in 18 patients with palpable nodal metastases in the neck who underwent radiotherapy for NPC. All patients had a pre-radiotherapy baseline and another study at least one year after radiotherapy. The largest node in each patient was evaluated for any change in the ultrasonographic features following radiotherapy.

One year after radiotherapy nodes returned to normal size for their respective areas, the shape of the node and the echogenic hilus also reverted to normal. However, the nodes are more echogenic than nodes in normal subjects. This distinguishes these nodes from nodes not affected by radiotherapy. The histological basis for this observation is presumed to be the result of fibrosis.

At first glance the post-radiotherapy nodes may resemble normal nodes, however subtle changes within the node and adjacent soft tissues can be recognized on ultrasonography. During long-term follow-up, the appearance of nodes at sites previously uninvolved or any change in the appearance of nodes should alert the sonologist to the possibility of recurrence.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahuja, A., Ying, M., Evans, R., King, W., Metreweli, C. (1995) The application of ultrasound criteria for malignancy in differentiating tuberculous cervical adenitis from metastatic nasopharyngeal carcinoma. Clinical Radiology 50: 391395.Google Scholar
Ahuja, A., Ying, M., Leung, S. F., Metreweli, C. (1996) The sonographic appearance and significance of cervical metastatic nodes following radiotherapy for nasopharyngeal carcinoma. Clinical Radiology 51: 698701.CrossRefGoogle Scholar
Baatenburg de Jong, R. J., Rongen, R. J., Laméris, J. S., Harthoorn, M., Verwoerd, C. D. A., Knegt, P. (1989) Metastatic neck disease: palpation vs. ultrasound examination. Archives of Otolaryngology – Head and Neck Surgery 115: 689690.CrossRefGoogle ScholarPubMed
Bruneton, J. N., Normand, F. (1987) Cervical lymph nodes. In Ultrasonography of the Neck. (Bruneton, J. N., ed.) Springer-Verlag, Berlin Heidelberg, pp 8192.CrossRefGoogle Scholar
Evans, R. M., Ahuja, A., Metreweli, C. (1993) The linear echogenic hilus in cervical lymphadenopathy – A sign of benignity or malignancy? Clinical Radiology 47: 262264.CrossRefGoogle ScholarPubMed
Rubaltelli, L., Proto, E., Salmaso, R., Bortoletto, P., Candiani, F., Cagol, P. (1990) Sonography of abnormal nodes in vitro: correlation of sonographic and histologic findings. American Journal of Roentgenology 155: 12411244.CrossRefGoogle ScholarPubMed
Sakai, F., Kiyono, K., Sone, S., Kondo, Y., Oguchi, M., Watanabe, T., Sakai, Y., Imai, Y., Takeda, S., Yamamoto, K., Ohta, H. (1988) Ultrasonic evaluation of cervical metastatic lymphadenopathy. Journal of Ultrasound in Medicine 7: 305310.Google Scholar
Shozushima, M., Suzuki, M., Nakashima, T., Yanagisawa, Y., Sakamaki, K., Takeda, Y. (1990) Ultrasound diagnosis of lymph node metastasis in head and neck cancer. Dento-Maxillo-Facial Radiology 19: 165170.CrossRefGoogle ScholarPubMed
Solbiati, L., Rizzatto, G., Bellotti, E., Montali, G., Cioffi, V., Croce, F. (1988) High-resolution sonography of cervical lymph nodes in head and neck cancer: criteria for differentiation of reactive versus malignant nodes. Radiology 169(P): 113.Google Scholar
Sutton, R. T., Reading, C. C., Charboneau, J. W., James, E. M., Grant, C. S., Hay, I. D. (1988) US-guided biopsy of neck masses in the postoperative management of patients with thyroid cancer. Radiology 168: 769772.CrossRefGoogle ScholarPubMed
Tohnosu, N., Onada, S., Isono, K. (1989) Ultrasonographic evaluation of cervical lymph node metastases in esophageal cancer with special reference between the short to long axis ratio (S/L) and the cancer content. Journal of Clinical Ultrasound 17: 101106.CrossRefGoogle Scholar
Vassallo, P., Wernecke, K., Roos, N., Peters, P. E. (1992) Differentiation of benign from malignant superficial lymphadenopathy: the role of high-resolution US. Radiology 183: 215220.Google Scholar
Wei, W. I., Lam, K. H., Ho, C. M., Sham, J. S. T., Lau, S. K. (1990) Efficacy of radical neck dissection for the control of cervical metastasis after radiotherapy for nasopharyngeal carcinoma. American Journal of Surgery 160: 439442.CrossRefGoogle ScholarPubMed
Ying, M., Ahuja, A., Brook, F., Brown, B., Metreweli, C. (1996) Sonographic appearance and distribution of normal cervical lymph nodes in a Chinese population. Journal of Ultrasound in Medicine 15: 431436.CrossRefGoogle ScholarPubMed