Imaging of nodal metastases in the head and neck

Yoshimi Anzai, James A Brunberg, Robert B. Lufkin

Research output: Contribution to journalArticlepeer-review

56 Scopus citations

Abstract

Therapeutic outcome of head and neck cancer is influenced strongly by the presence of nodal metastases. Sensitivity and specificity of the physical examination for the diagnosis of nodal metastasis is unsatisfactory resulting in both false negatives and false positives of 25 to 40%. Preoperative detection of nodal metastases therefore becomes one of the important goals of imaging studies of patients with head and neck cancer. Despite several advanced techniques and the wide clinical use of MR, MR has surprisingly added little to the diagnostic accuracy of contrast-enhanced CT. Although CT and MR allow detection of abnormally enlarged nodes or necrotic nodes, neither borderline-sized nodes without necrosis nor extracapsular spread are reliably differentiated from reactive or normal nodes in patients with head and neck cancer. Lack of definitive diagnostic methods of metastatic lymph nodes is a serious shortcoming in the preoperative workup for patients with head and neck cancer. To avoid missing small metastatic nodes, a large number of patients clinically staged as NO have undergone elective neck dissection to exclude metastases. With development of more tissue-specific imaging techniques, patients can be better characterized according to the status of nodal disease so that an appropriate therapeutic protocol can be designed for an individual case.

Original languageEnglish (US)
Pages (from-to)774-783
Number of pages10
JournalJournal of Magnetic Resonance Imaging
Volume7
Issue number5
DOIs
StatePublished - Sep 1997
Externally publishedYes

Keywords

  • Head and neck neoplasm
  • Iron oxide
  • Lymphatic system
  • Magnetic resonance imaging
  • Nodal metastasis
  • Positron emission tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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