Comparison of ultrasound-fine needle aspiration and computed tomography in patients undergoing elective neck dissection

• Published in: Head & neck Vol. 19; no. 7; pp. 604 - 610
• Main Authors: Righi, Paul D., Kopecky, Kenyon K., Caldemeyer, Karen S., Ball, Valerie A., Weisberger, Edward C., Radpour, Shokri
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.10.1997; John Wiley & Sons
• Subjects: aspiration; Biological and medical sciences; Biopsy, Needle - methods; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; computed tomography; Diagnostic Imaging; Elective Surgical Procedures; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - secondary; Head and Neck Neoplasms - surgery; Humans; Lymph Node Excision; Lymphatic Metastasis; Medical sciences; metastases; neck; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Palpation; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed; Tumors; ultrasound; Sonography; Human; Radiodiagnosis; Lymph node; Aspiration; Metastasis; Malignant tumor; Medical screening; Fine needle; Echography; Head and neck; Medical imagery; ENT disease; Computerized axial tomography; Comparative study
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/(SICI)1097-0347(199710)19:7<604::AID-HED7>3.0.CO;2-B

Background Ultrasound of the neck with fine needle aspiration (US‐FNA) of suspicious lymph nodes has potential advantages over other radiologic techniques as a screening method for the N0 neck in head and neck cancer. Methods Twenty‐five patients with head and neck cancer who underwent both US of the neck with FNA of any suspicious lymph nodes and neck computed tomography (CT) prior to elective neck dissection were studied. The majority of patients had squamous cell carcinoma (SCC) of the upper aerodigestive tract. Histopathologic results of the neck specimens were compared with each screening technique (palpation, US, US‐FNA, CT). Results Computed tomography (87.9%) and US‐FNA (84.9%) had similar overall accuracy in terms of screening the N0 neck in our study and were superior to palpation (69.7%) and US alone (72.7%). Specificity was 100% for both CT and US‐FNA, with a sensitivity of 60% for CT and 50% for US‐FNA. Ultrasound‐FNA and CT showed false‐negative examinations on virtually the same cases. Conclusions Overall, US‐FNA was comparable to CT in screening the N0 neck in our study. The choice of which modality to employ for imaging the clinically negative neck depends on a number of factors, including the location and clinical extent of the primary tumor as well as the experience and preference of the head and neck surgeon and radiologist. © 1997 John Wiley & Sons, Inc. Head Neck 19: 604–610, 1997.