title: Neck ultrasound in staging squamous oesophageal carcinoma - a high yield technique.
abstract: OBJECTIVE
  This study evaluates the use of neck ultrasound in staging squamous oesophageal carcinoma.
  
  
  METHODS
  A prospective analysis of the clinical, neck ultrasound (US) and thoraco-abdominal computed tomography (CT) findings in 121 patients with squamous oesophageal carcinoma at presentation was performed. The relationship between malignant neck nodes, mediastinal and abdominal adenopathy, location and size of the primary tumour was analysed.
  
  
  RESULTS
  Ten of 121 patients (8%) had clinically palpable neck nodes which were deemed malignant in six (5%) following US and fine-needle aspiration for cytology. Of those 111 patients with no palpable neck nodes, 31 (28%) had malignant nodes shown on US. The more cephalad the location of the primary tumour, the higher the frequency of malignant neck nodes which were found in 80%, 52%, 29% and 9% of cervical, upper thoracic, mid-thoracic and lower thoracic oesophageal tumours, respectively. Eleven (29%) of the 38 patients with malignant neck nodes shown on US had no CT evidence of additional adenopathy in the mediastinum or upper abdomen. Neck US altered TNM staging in 22/121 (18%) patients at presentation.
  
  
  CONCLUSIONS
  Neck US frequently detects clinically impalpable metastatic nodes leading to altered TNM staging in patients with squamous oesophageal carcinoma. We advocate its routine use when staging squamous oesophageal carcinoma.
authors.affiliation: Departments of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, New Terrorities. J31griffith@cuhk.edu.hk
authors.forename: J F
authors.initials: JF
authors.lastname: Griffith
authors.forename: A C
authors.initials: AC
authors.lastname: Chan
authors.forename: A T
authors.initials: AT
authors.lastname: Ahuja
authors.forename: S F
authors.initials: SF
authors.lastname: Leung
authors.forename: L T
authors.initials: LT
authors.lastname: Chow
authors.forename: S C
authors.initials: SC
authors.lastname: Chung
authors.forename: C
authors.initials: C
authors.lastname: Metreweli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009333:Neck; D009367:Neoplasm Staging; D011446:Prospective Studies; D014463:Ultrasonography