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Diagnosis of Cervical Lymph Node Metastasis in Head and Neck Cancer: Evidence-Based Neuroimaging

  • Matakazu Furukawa
  • Yoshimi Anzai
Part of the Evidence-Based Imaging book series (Evidence-Based Imag.)

Abstract

Nodal metastasis is one of the most significant prognostic factors in head and neck cancer (HNC). Imaging plays an essential role in detecting metastatic lymph nodes and has dramatically improved staging accuracy over physical examination. Various imaging techniques are currently available to assess nodal staging for patients with HNC. This comprehensive evidence-based review summarizes diagnostic accuracy of cervical lymph node metastases using various imaging techniques (CT, MR, US, and PET) for patients with HNC. Size criteria have obvious shortcomings for staging of HNC as many metastatic nodes are normal in size. Physiologic and metabolic information certainly improves diagnostic accuracy. Special attention was made to clarify the detail method of study analysis, i.e. diagnostic accuracy per each lymph node, per nodal level, or per a patient. The level of analysis has an important implication for interpretation of accuracy data in each study. The results were analyzed separately for all HNC patients and N0 patients where no palpable lymph nodes are present clinically, as the latter presents more challenge on imaging. Additionally, the imaging assessment of residual nodal disease following chemoradiotherapy for HNC was addressed.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of WashingtonSeattleUSA

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