Iron oxide particle-enhanced magnetic resonance imaging for detection of benign lymph nodes in the head and neck: how reliable are the results?
OBJECTIVE
To evaluate the accuracy of ultrasmall paramagnetic iron oxide (USPIO: Sinerem)-enhanced MRI in patients with head and neck cancer and enlarged lymph nodes compared with current staging examinations using histology as a gold standard.


METHODS
Seventeen patients with a histologically proven squamous cell cancer of the head and neck (SCCHN) and different N-stages underwent a non-enhanced and a USPIO-enhanced MRI examination. Signal intensity (SI) was measured in a region of interest evaluation. Pathohistological examination was used as a reference.


RESULTS
On a patient basis, USPIO-enhanced MRI showed a higher specificity and diagnostic accuracy (94%) compared with non-enhanced MRI (53%). One patient showed a lymph node of 6 mm in the short axial diameter which was suggested as being metastatic in Sinerem-enhanced MRI according to the enhancement pattern of Sinerem. This patient was staged as N1 with Sinerem-enhanced MRI. The histopathological examination did not confirm the Sinerem-enhanced MRI result.


CONCLUSIONS
The high values for the specifity and diagnostic accuracy of Sinerem- enhanced MRI justifies further investigations with this contrast agent. USPIO-enhanced MRI could be advantageous in avoiding surgical overtreatment.
Baghi
Mehran
M
Department of ENT-Surgery, J.W. Goethe University, School of Medicine, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
Mack
Martin G
MG
Wagenblast
Jens
J
Hambek
Markus
M
Rieger
Jörg
J
Bisdas
Sotirios
S
Gstoettner
Wolfgang
W
Engels
Knut
K
Vogl
Thomas
T
Knecht
Rainald
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005290:Ferric Compounds / Q000378:metabolism*; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging
D005290:Ferric Compounds; C000499:ferric oxide