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Three-dimensional doppler ultrasonography in assessing nodal metastases and staging head and neck cancer

Authors

  • Yu-Shih Lai MD, MS,

    1. Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
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  • Chun-Ying Kuo MD,

    1. Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
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  • Mu-Kuan Chen MD, PhD,

    1. Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
    2. Mingdao University, Changhua, Taiwan
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  • Hui-Chuan Chen PhD

    Corresponding author
    1. Providence University, Taichung, Taiwan
    • Send correspondence to Mu-Kuan Chen, Chief of Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, 135 Nanxiao St., Changhua City, Changhua County 500, Taiwan. E-mail: 112780@cch.org.tw

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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

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.

Methods

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.

Results

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%.

Conclusions

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

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