Ultrasound-Guided Fine Needle Aspiration Cytology in the Assessment of Cervical Metastasis in Patients Undergoing Elective Neck Dissection

AUTHORS

Payman Dabirmoghaddam 1 , * , Shervin Sharifkashani 2 , Leila Mashali 3

1 Otolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Otolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences

How to Cite: Dabirmoghaddam P, Sharifkashani S, Mashali L. Ultrasound-Guided Fine Needle Aspiration Cytology in the Assessment of Cervical Metastasis in Patients Undergoing Elective Neck Dissection, Iran J Radiol. Online ahead of Print ; 11(3):7928. doi: 10.5812/iranjradiol.7928.

ARTICLE INFORMATION

Iranian Journal of Radiology: 11 (3); 7928
Published Online: July 31, 2014
Article Type: Research Article
Received: August 26, 2012
Crossmark

Crossmark

CHEKING

READ FULL TEXT
Abstract

Background: In head and neck cancer patients, diagnosis of metastatic cervical adenopathy is essential for treatment planning and prognosis assessment. Treatment of patients with head and neck cancer with clinically negative cervical lymph node (N0) remains controversial. While routine neck treatment would result in overtreatment in many patients, observation may delay the diagnosis and decrease the patients survival.

Objectives: To gain insights into the unclear questions regarding the value of diagnostic modalities in patients with N0 neck, this study was designed to compare the diagnostic efficacy of palpation, ultrasonography (US) and ultrasound-guided fine needle aspiration (USGFNA) in detecting cervical lymph node metastasis.

Patients and Methods: Forty-two patients with head and neck cancer who underwent US and USGFNA prior to elective neck dissection were studied. Histopathologic findings of the neck specimens were compared with each diagnostic technique.

Results: Of the 53 neck dissection specimens, histopathology showed metastases in 16 cases. The overall accuracy of USGFNA, US and palpation was 96%, 68% and 70%, respectively. The specificity of USGFNA was superior to palpation and US alone. USGFNA had the highest sensitivity, predictive value and accuracy in detecting cervical metastases compared with other performed tests.

Conclusion: In our study, USGFNA was superior to palpation and US in detecting metastasis in clinically negative necks. This method can be recommended as a diagnostic tool in preoperative assessment of patients without palpable metastasis, but further investigations are needed before this modality could be considered as an alternative to elective neck dissection.

Keywords

Cancer of Head and Neck Lymph Nodes Palpation Ultrasonography Neoplasm Metastasis

© 2014, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

Full Text

Full text is available in PDF

COMMENTS

LEAVE A COMMENT HERE: