Clinical impact of short tau inversion recovery MRI on staging and management in patients with cervical lymph node metastases of head and neck squamous cell carcinomas.
BACKGROUND
We investigated the incremental diagnostic value of short tau inversion recovery (STIR) MRI to detect cervical nodal metastases in head and neck squamous cell carcinoma.


METHODS
Thirty-six patients with cervical nodal metastases underwent MRI preceding neck dissection. Two readers evaluated MRI versus MRI with STIR. Level-based analysis was performed: interobserver agreements (kappa) for detecting normal and metastatic lymph nodes; sensitivities and specificities for detecting at least 1 metastatic lymph node per level; linear regression analysis to determine performances of MRI with STIR in detecting correct numbers of normal and metastatic lymph nodes. Histopathology was the reference standard.


RESULTS
One hundred eighty neck levels were evaluated. MRI with STIR showed better kappas for metastatic and normal lymph nodes, was more accurate to estimate numbers of metastatic and normal lymph nodes, and showed improvement of sensitivities and specificities.


CONCLUSIONS
Incorporation of STIR into the conventional MR protocol significantly improves the detection of cervical lymph node metastases.
de Bondt
Bert-Jan
BJ
Department of Radiology, University Hospital Maastricht, Maastricht, The Netherlands. rbj.de.bondt@mumc.nl
Stokroos
Robert
R
Casselman
Jan W
JW
van Engelshoven
Jos M A
JM
Beets-Tan
Regina G H
RG
Kessels
Fons G H
FG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D015588:Observer Variation; D011237:Predictive Value of Tests