title: Three-dimensional Doppler ultrasonography in assessing nodal metastases and staging head and neck cancer.
abstract: OBJECTIVE
  This study built a simple prediction system by three-dimensional (3D) Doppler ultrasonography to evaluate the metastases of cervical lymph nodes and the preoperative initial stage of head and neck cancer.
  
  
  METHODS
  Retrospective review of cervical lymph node ultrasound features and prospective nodal staging of head and neck cancer.
  
  
  METHODS
  One hundred thirty-nine suspicious cervical lymph nodes, receiving 3D Doppler ultrasonography, were used to establish a predictive model. Then nodal metastasis was initially staged from 27 patients with head and neck cancer by this model.
  
  
  RESULTS
  The prediction system was constructed by major (internal matting, vascularity pattern) and minor (age ≥ 40 years, short/long ratio ≥ 0.5) sign categories. Cervical lymph node was regarded as metastasis with the presence of one major and any of the other factors. The predictive model resulted in sensitivity of 91.9%, specificity of 88.2%, and accuracy of 89.2%. Then we evaluated the initial staging of patients with head and neck cancer by this model, and the rate of correct N staging was 92.6%.
  
  
  CONCLUSIONS
  According to this prediction system, 3D Doppler ultrasonography definitely provides a rapid and reliable method for initial staging of head and neck cancer.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Yu-Shih
authors.initials: YS
authors.lastname: Lai
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Kuo
authors.forename: Mu-Kuan
authors.initials: MK
authors.lastname: Chen
authors.forename: Hui-Chuan
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler / Q000379:methods*; D055815:Young Adult
keywords: Three-dimensional Doppler ultrasonography; initial staging; metastatic cervical lymph nodes; prediction model