Real-time and computerized sonographic scoring system for predicting malignant cervical lymphadenopathy.
BACKGROUND
To identify malignant cervical lymphadenopathy, we established a real-time, computerized scoring system based on sonographic findings and demographic data.


METHODS
One hundred eight patients with neck lymphadenopathy, receiving ultrasonography and ultrasound-guided fine-needle aspiration (US-FNA), were used to construct a predictive model. This model was validated by another independent patient cohort.


RESULTS
A predictive scoring scale was proposed by multivariate logistic regression analysis: 0.06 x (age) + 4.76 x (S/L ratio) + 2.15 x (internal echo) + 1.80 x (vascular pattern). Cervical lymphadenopathy was regarded as malignant with a score >or=7. The formula was programmed into a synchronized, computerized sonographic reporting system. Prospective validation of this predictive tool showed excellent sensitivity (100%), specificity (88.0%), and overall accuracy (90.1%).


CONCLUSIONS
A real-time and practical sonographic scoring system was built and validated to provide the physician prompt and reliable probability guidance for performing US-FNA cytology in managing cervical lymphadenopathy.
Liao
Li-Jen
LJ
Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.
Wang
Chi-Te
CT
Young
Yi-Ho
YH
Cheng
Po-Wen
PW
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002648:Child; D015331:Cohort Studies; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009333:Neck; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional; D055815:Young Adult