Initial staging of the neck in head and neck squamous cell carcinoma: A comparison of CT, PET/CT, and ultrasound-guided fine-needle aspiration cytology
Article first published online: 20 MAY 2011
Copyright © 2011 Wiley Periodicals, Inc.
Head & Neck
Volume 34, Issue 4, pages 469–476, April 2012
How to Cite
Stoeckli, S. J., Haerle, S. K., Strobel, K., Haile, S. R., Hany, T. F. and Schuknecht, B. (2012), Initial staging of the neck in head and neck squamous cell carcinoma: A comparison of CT, PET/CT, and ultrasound-guided fine-needle aspiration cytology. Head Neck, 34: 469–476. doi: 10.1002/hed.21764
- Issue published online: 3 MAR 2012
- Article first published online: 20 MAY 2011
- Manuscript Accepted: 24 JAN 2011
- Manuscript Revised: 20 DEC 2010
- Manuscript Received: 14 AUG 2010
- head and neck squamous cell carcinoma;
- neck dissection
The aim of this study was to compare imaging modalities for staging the neck in a prospective cohort of patients evaluated by CT, ultrasound with fine-needle aspiration cytology (FNAC), and [18F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT with the histologic evaluation of the neck dissection as the standard of reference.
In all, 76 consecutive patients were prospectively enrolled.
Ultrasound-guided FNAC showed the highest level of agreement with histology for exact N classification. Ultrasound-guided FNAC showed the smallest percentage of overstaged patients, 7%, versus 16% with PET/CT, 13% with CT, and 13% with ultrasound. The rate of understaged patients was comparable between the imaging modalities. With regard to the endpoint N0 versus N+ there were no statistically significant differences to be found.
Ultrasound-guided FNAC seems to correlate best with histologic staging compared with PET/CT and CT. None of the modality is reliable enough to replace elective neck treatment in cN0 necks. © 2011 Wiley Periodicals, Inc. Head Neck, 2012