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Sensitivity and specificity of computed tomography for detection of extranodal spread from metastatic head and neck squamous cell carcinoma

Published online by Cambridge University Press:  12 January 2009

M A Souter ,
R S Allison ,
J H Clarkson ,
I A Cowan ,
M H Coates  and
J E Wells
M A Souter*
Affiliation:
Department of Otolaryngology Head Neck Surgery, Christchurch Hospital, Christchurch, New Zealand
R S Allison
Affiliation:
Department of Otolaryngology Head Neck Surgery, Christchurch Hospital, Christchurch, New Zealand
J H Clarkson
Affiliation:
Department of Otolaryngology Head Neck Surgery, Christchurch Hospital, Christchurch, New Zealand
I A Cowan
Affiliation:
Department of Radiology, Christchurch Hospital, Christchurch, New Zealand
M H Coates
Affiliation:
Department of Radiology, Christchurch Hospital, Christchurch, New Zealand
J E Wells
Affiliation:
Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand
*
Address for correspondence: Dr Melanie Souter, c/o 32 Rata Street, Riccarton, Christchurch 8041, New Zealand. Fax: +64 9 4196975 E-mail: [email protected]
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Abstract

Aim:

To estimate the sensitivity and specificity of computed tomography used for the detection of extranodal spread of metastatic head and neck squamous cell carcinoma, by experienced head and neck radiologists.

Materials and methods:

Participants had undergone a neck dissection for head and neck squamous cell carcinoma, together with computed tomography scanning prior to surgery (accessible for reporting). Computed tomography images were independently examined by two experienced head and neck radiologists. Nodal involvement by squamous cell carcinoma and the presence or absence of extranodal spread were recorded. Results were compared to the histological specimen. The sensitivity, specificity and positive predictive value of using computed tomography for the detection of nodal involvement and presence or absence of extranodal spread were estimated, and 95 per cent confidence intervals were calculated.

Results and analysis:

The study analysed 149 neck dissections. When using computed tomography to detect the extranodal spread of head and neck squamous cell carcinoma, radiologists A and B had sensitivities of 66 and 80 per cent, specificities of 91 and 90 per cent, and positive predictive values of 85 and 87 per cent, respectively.

Discussion:

The sensitivity and specificity of radiological detection of extranodal spread from head and neck squamous cell carcinoma is not well reported in the literature. Accuracy of reporting improves in the hands of experienced head and neck radiologists. This finding has clinical implications for surgical planning and adjuvant therapy requirements.

Keywords

Carcinoma, Squamous CellHead and Neck NeoplasmsSensitivity and SpecificityNeoplasm Metastasis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 7 , July 2009 , pp. 778 - 782
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the New Zealand Society of Otolaryngology Head and Neck Surgery Annual Scientific Meeting, 31 October – 3 November 2006, Timaru, New Zealand.

References

1 Don, D, Yoshimi, A, Lufkin, R, Fu, Y, Calcaterra, T. Evaluation of cervical lymph node metastasis in squamous cell carcinoma of the head and neck. Laryngoscope 1995;105:669–74CrossRefGoogle ScholarPubMed
2 Snow, G, Annyas, A, Van Slooten, E, Bartelink, H, Hart, A. Prognostic factors of neck node metastasis. Clin Otolaryngol 1982;7:185–92CrossRefGoogle ScholarPubMed
3 Puri, S, Fan, C, Hanna, E. Significance of extracapsular lymph node metastasis in patients with head and neck squamous cell carcinoma. Curr Opin Otolaryngol Head Neck Surg 2003;11:119–23CrossRefGoogle ScholarPubMed
4 Som, P. Lymph nodes of the neck. Radiology 1987;165:593–600CrossRefGoogle ScholarPubMed
5 Steinkamp, H, van der Hoeck, E, Bock, J, Felix, R. The extracapsular spread of cervical lymph node metastasis: diagnostic value of computed tomography [in German]. Rofo 1999;170:457–62CrossRefGoogle ScholarPubMed
6 Carvalho, P, Baldwin, D, Carter, R, Parsons, C. Accuracy of CT in detecting squamous cell carcinoma metastasis in cervical lymph nodes. Clin Radiol 1991;44:79–81CrossRefGoogle ScholarPubMed
7 Steinkamp, H, Beck, A, Werk, M, Felix, R. Extracapsular spread of cervical lymph node metastasis: diagnostic value of magnetic resonance imaging [in German]. Rofo 2002;174:50–5CrossRefGoogle Scholar
8 Anzai, Y, Brunberg, J, Lufkin, R. Imaging of nodal metastasis in the head and neck. J Magn Reson Imaging 1997;7:774–83CrossRefGoogle ScholarPubMed
9 Akoglu, E, Dutpek, M, Bekis, R, Degirmenci, B, Ada, E, Guneri, A. Assessment of cervical lymph node metastasis with different methods in patients with head and neck squamous cell carcinoma. J Otolaryngol 2005;34:384–94CrossRefGoogle ScholarPubMed
10 Stucksen, T, Kovacs, A, Adams, S, Baum, R. Staging of the neck in patients with oral cavity squamous cell carcinomas: a prospective comparison of PET, ultrasound, CT and MRI. J Craniomaxillofac Surg 2000;28:319–24CrossRefGoogle Scholar
11 Yousem, D, Som, P, Hackney, D, Schwaibold, F, Hendrix, R. Central nodal necrosis and extracapsular neoplastic spread in cervical lymph nodes: MR imaging versus CT. Radiology 1992;182:753–59CrossRefGoogle ScholarPubMed
12 Kutler, D, Wong, R, Schoder, H, Kraus, D. Current status of positron-emission tomography scanning in the evaluation and follow-up of patients with head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 2006;14:73–81CrossRefGoogle ScholarPubMed
13 Richards, PS, Peacock, TE. The role of ultrasound in the detection of cervical lymph node metastasis in clinically N0 squamous cell carcinoma of the head and neck. Cancer Imaging 2007;7:167–78CrossRefGoogle ScholarPubMed
14 Bernier, J, Cooper, JS, Pajak, TF, van Glabbeke, M, Bourhis, J, Forastiere, A et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC and RTOG. Head Neck 2005;27:843–50CrossRefGoogle Scholar
15 Myers, J, Greenberg, J, Vivian, M, Roberts, D. Extracapsular spread. A significant predictor of treatment failure in patients with squamous cell carcinoma of the tongue. Cancer 2001;92:3030–63.0.CO;2-P>CrossRefGoogle ScholarPubMed
16 Cooper, J, Pajak, TF, Forastiere, AA, Jacobs, J, Campbell, BH, Saxman, SB et al. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 2004;350:1937–44CrossRefGoogle ScholarPubMed