Can extranodal spread in head and neck cancer be detected on MR imaging

Wouter L. Lodder*, Charlotte A. H. Lange, Marie-Louise F. van Velthuysen, Michael Hauptmann, Alfons J. M. Balm, Michiel W. M. van den Brekel, Frank A. Pameijer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

25 Citations (Scopus)

Abstract

Objectives: The aim of this study is to determine a set of MRI lymph node characteristics predictive for extranodal tumor spread (ENS) in head and neck cancer patients.

Methods: In 39 patients, 60 lymph nodes with on MRI a minimal axial diameter of more than 1 cm or an inhomogeneous enhancement were studied. Two radiologists evaluated all MR-images for findings potentially indicative of the presence of ENS. Sensitivity, specificity and odds ratios based on logistic regression were calculated.

Results: On MR-imaging, 20 lymph nodes were staged positive for ENS. On histopathology, 30 nodes were positive for ENS. In total, 14 nodes (23%) were scored differently on MR-imaging and histopathology. The MR-finding "infiltration of adjacent planes" established a specificity of 100% (lower 90% confidence bound: 91%) and sensitivity of 50% (95% confidence interval [CI]: 28-72%).

Conclusion: The MRI finding "infiltration of adjacent planes" may be high enough (100% in our study) to be used for treatment planning. (C) 2013 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)626-633
Number of pages8
JournalOral Oncology
Volume49
Issue number6
DOIs
Publication statusPublished - Jun-2013

Keywords

  • Extranodal spread
  • MR imaging
  • Histopathology
  • Head and neck cancer
  • Lymph node
  • SQUAMOUS-CELL CARCINOMA
  • LYMPH-NODE METASTASIS
  • EXTRACAPSULAR SPREAD
  • POSTOPERATIVE RADIOTHERAPY
  • COMPUTED-TOMOGRAPHY
  • NEOPLASTIC SPREAD
  • DISSECTION
  • SURGERY
  • CT
  • CLASSIFICATION

Cite this