title: Occult metastatic neck disease: detection with US and US-guided fine-needle aspiration cytology.
abstract: The authors performed a prospective study of the value of ultrasonography (US) and US-guided fine-needle aspiration cytology (FNAC) for assessment of N0 lesions in the neck. Preoperative US was performed in 107 patients with squamous cell carcinoma of the head and neck, who underwent 132 elective neck dissections. During the US examination of the last 54 patients, who underwent 70 elective neck dissections, US-guided FNAC was performed. US alone was found to be an unreliable method for detecting occult lymph node metastasis; the accuracy never exceeded 70% (93 of 132), with a sensitivity of 60% (32 of 53) and a specificity of 77% (61 of 79). In contrast, US-guided FNAC had an accuracy of 89% (62 of 70), a sensitivity of 76% (25 of 33), and a specificity of 100% (37 of 37). Because of the high sensitivity and specificity of US-guided FNAC for the assessment of the N0 neck, this modality may play an important role in directing treatment of these patients in the future.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Free University Hospital, Amsterdam, The Netherlands.
authors.forename: M W
authors.initials: MW
authors.lastname: van den Brekel
authors.forename: J A
authors.initials: JA
authors.lastname: Castelijns
authors.forename: H V
authors.initials: HV
authors.lastname: Stel
authors.forename: W J
authors.initials: WJ
authors.lastname: Luth
authors.forename: J
authors.initials: J
authors.lastname: Valk
authors.forename: I
authors.initials: I
authors.lastname: van der Waal
authors.forename: G B
authors.initials: GB
authors.lastname: Snow
mesh_terms: D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D037981:Neck Dissection; D009382:Neoplasms, Unknown Primary / Q000473:pathology; D012680:Sensitivity and Specificity; D014463:Ultrasonography