Regional metastasis in head and neck squamous cell carcinoma: revised value of US with US-guided FNAB.
OBJECTIVE
To verify the acclaimed accuracy of ultrasound (US) combined with US-guided fine-needle aspiration biopsy (FNAB) in the detection of lymph node metastasis in the neck and to evaluate the interobserver variability.


METHODS
In a prospective, multicenter study of 185 patients with head and neck squamous cell carcinoma, US (n=238 neck sides) with US-guided FNAB (n=178 neck sides) was used for evaluation of the lymph node status of the neck. Findings were correlated with those of histopathologic examination in 238 neck sides.


RESULTS
US with US-guided FNAB had a sensitivity of 77% and a specificity of 100%. Nineteen of 178 aspirations were nondiagnostic. There were no significant differences between the four participating hospitals or the individual sonologists (P>.05).


CONCLUSIONS
Sensitivity of US with US-guided FNAB was slightly lower compared with previous reports. Specificity was similar to previous reports. Interobserver variability appeared to be low. The validity of US with US-guided FNAB is high and warrants widespread use of the procedure for evaluation of the neck.
Takes
R P
RP
Department of Otolaryngology, University Hospital Leiden, The Netherlands.
Knegt
P
P
Manni
J J
JJ
Meeuwis
C A
CA
Marres
H A
HA
Spoelstra
H A
HA
de Boer
M F
MF
Bruaset
I
I
van Oostayen
J A
JA
Laméris
J S
JS
Kruyt
R H
RH
Joosten
F B
FB
van Krieken
J H
JH
Bosman
F T
FT
Henzen-Logmans
S C
SC
Wiersma-van Tilburg
J M
JM
Hermans
J
J
Baatenburg de Jong
R J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009333:Neck; D015588:Observer Variation; D010173:Palpation; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography