Utility of color Doppler ultrasound in evaluating the status of cervical lymph nodes in oral cancer

• Published in: Oral surgery, oral medicine, oral pathology, oral radiology and endodontics Vol. 108; no. 2; pp. 255 - 263
• Main Authors: Dangore-Khasbage, Suwarna, MDS, Degwekar, Shirish S., MDS, Bhowate, Rahul R., MDS, Banode, Pankaj J., MD, Bhake, Arvind, MD, Choudhary, Minal S., MDS, Lohe, Vidya K., MDS
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.08.2009; Elsevier
• Subjects: Biological and medical sciences; Cardiovascular system; Dentistry; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Lymph Nodes - blood supply; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Diseases - diagnostic imaging; Lymphatic Diseases - pathology; Lymphatic Metastasis - diagnostic imaging; Male; Medical sciences; Mouth Neoplasms - diagnostic imaging; Mouth Neoplasms - pathology; Neck; Neoplasm Staging - methods; Otorhinolaryngology. Stomatology; Prospective Studies; Regional Blood Flow; Sensitivity and Specificity; Sentinel Lymph Node Biopsy; Statistics, Nonparametric; Surgery; Tumors; Ultrasonic investigative techniques; Ultrasonography, Doppler, Color; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Sonography; Doppler ultrasound study; Oral cancer; Stomatology; Color; Cervical ganglion; Oral cavity disease; Malignant tumor; Ultrasound; Cancer
• ISSN: 1079-2104; 1528-395X
• DOI: 10.1016/j.tripleo.2009.01.003

Objective The aim was to study the utility of color Doppler ultrasound (CDUS) in diagnosis of cervical lymphadenopathy in oral cancer patients. Study design In a prospective study, 70 cervical lymph nodes in 30 known primary oral cancer patients were evaluated with CDUS during a period of 8 months. The intranodal perfusion sites and vascular resistance were the key CDUS features used to differentiate between reactive and metastatic cervical lymph nodes. Histopathologic confirmations were obtained by excisional biopsy of the lymph nodes. The results of preoperative clinical palpation of cervical lymph nodes and CDUS evaluation were compared with histopathologic outcome. Results Clinical evaluation suspected 61 cervical lymph nodes to be malignant. According to the CDUS, out of 70 nodes, 49 lymph nodes showed features of benign lymphadenopathy and 21 lymph nodes showed features of malignant lymphadenopathy, whereas histopathologic evaluations were in favor of reactive for 57 (81.42%) and for malignant lymphadenopathy in 13 (18.57%). Conclusion The CDUS evaluation was found to be highly significant with a sensitivity of 92.90% and a specificity of 84.21%, after comparing the CDUS findings with histopathologic findings.