title: Can axial-based nodal size criteria be used in other imaging planes to accurately determine "enlarged" head and neck lymph nodes?
abstract: Objective. We evaluate if axial-based lymph node size criteria can be applied to coronal and sagittal planes. Methods. Fifty pretreatment computed tomographic (CT) neck exams were evaluated in patients with head and neck squamous cell carcinoma (SCCa) and neck lymphadenopathy. Axial-based size criteria were applied to all 3 imaging planes, measured, and classified as "enlarged" if equal to or exceeding size criteria. Results. 222 lymph nodes were "enlarged" in one imaging plane; however, 53.2% (118/222) of these were "enlarged" in all 3 planes. Classification concordance between axial versus coronal/sagittal planes was poor (kappa = -0.09 and -0.07, resp., P < 0.05). The McNemar test showed systematic misclassification when comparing axial versus coronal (P < 0.001) and axial versus sagittal (P < 0.001) planes. Conclusion. Classification of "enlarged" lymph nodes differs between axial versus coronal/sagittal imaging planes when axial-based nodal size criteria are applied independently to all three imaging planes, and exclusively used without other morphologic nodal data.
authors: Princess Margaret Cancer Centre, Joint Department of Medical Imaging, University of Toronto, 610 University Avenue, Room 3-956, Toronto, ON, Canada M5G 2M9.
authors: Eric S
authors: ES
authors: Bartlett
authors: Thomas D
authors: TD
authors: Walters
authors: Eugene
authors: E
authors: Yu
references: Radiology. 1990 Nov;177(2):379-84
references: 2217772
references: AJR Am J Roentgenol. 1992 May;158(5):961-9
references: 1566697
references: AJR Am J Roentgenol. 2000 Mar;174(3):837-44
references: 10701636
references: Cancer Imaging. 2004 Jun 25;4(2):116-20
references: 18250018
references: Eur Radiol. 2007 May;17(5):1235-41
references: 17252236