• Three-dimensional Doppler ultrasonography;
  • metastatic cervical lymph nodes;
  • prediction model;
  • initial staging


This study built a simple prediction system by three-dimensional (3D) Doppler ultrasonography to evaluate the metastases of cervical lymph nodes and the preoperative initial stage of head and neck cancer.

Study Design

Retrospective review of cervical lymph node ultrasound features and prospective nodal staging of head and neck cancer.


One hundred thirty-nine suspicious cervical lymph nodes, receiving 3D Doppler ultrasonography, were used to establish a predictive model. Then nodal metastasis was initially staged from 27 patients with head and neck cancer by this model.


The prediction system was constructed by major (internal matting, vascularity pattern) and minor (age ≥ 40 years, short/long ratio ≥ 0.5) sign categories. Cervical lymph node was regarded as metastasis with the presence of one major and any of the other factors. The predictive model resulted in sensitivity of 91.9%, specificity of 88.2%, and accuracy of 89.2%. Then we evaluated the initial staging of patients with head and neck cancer by this model, and the rate of correct N staging was 92.6%.


According to this prediction system, 3D Doppler ultrasonography definitely provides a rapid and reliable method for initial staging of head and neck cancer.

Level of Evidence

2b. Laryngoscope, 123:3037–3042, 2013