title: Can extranodal spread in head and neck cancer be detected on MR imaging.
abstract: OBJECTIVE
  The aim of this study is to determine a set of MRI lymph node characteristics predictive for extranodal tumor spread (ENS) in head and neck cancer patients.
  
  
  METHODS
  In 39 patients, 60 lymph nodes with on MRI a minimal axial diameter of more than 1cm or an inhomogeneous enhancement were studied. Two radiologists evaluated all MR-images for findings potentially indicative of the presence of ENS. Sensitivity, specificity and odds ratios based on logistic regression were calculated.
  
  
  RESULTS
  On MR-imaging, 20 lymph nodes were staged positive for ENS. On histopathology, 30 nodes were positive for ENS. In total, 14 nodes (23%) were scored differently on MR-imaging and histopathology. The MR-finding "infiltration of adjacent planes" established a specificity of 100% (lower 90% confidence bound: 91%) and sensitivity of 50% (95% confidence interval [CI]: 28-72%).
  
  
  CONCLUSIONS
  The MRI finding "infiltration of adjacent planes" may be high enough (100% in our study) to be used for treatment planning.
authors.affiliation: Department of Head & Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. w.l.lodder@gmail.com
authors.forename: Wouter L
authors.initials: WL
authors.lastname: Lodder
authors.forename: Charlotte A H
authors.initials: CA
authors.lastname: Lange
authors.forename: Marie-Louise F
authors.initials: ML
authors.lastname: van Velthuysen
authors.forename: Michael
authors.initials: M
authors.lastname: Hauptmann
authors.forename: Alfons J M
authors.initials: AJ
authors.lastname: Balm
authors.forename: Michiel W M
authors.initials: MW
authors.lastname: van den Brekel
authors.forename: Frank A
authors.initials: FA
authors.lastname: Pameijer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis