Can contrast-enhanced ultrasound distinguish malignant from reactive lymph nodes in patients with head and neck cancers?
The purpose of this study was to investigate the utility of contrast-enhanced ultrasound in differentiating benign from malignant cervical lymph nodes in patients with squamous cell carcinoma of the head and neck. A consecutive series of 17 patients with known head and neck malignancy scheduled for neck surgery and lymph node clearance were recruited for contrast-enhanced ultrasound evaluation. Sonographic signal intensity as a function of time, comparing features of time to peak, time to arrival and time to wash-out, was quantified. The selected node was removed surgically and submitted for histology. Contrast-enhanced ultrasound examination had 100% sensitivity and 85.7% specificity for lymph node involvement. Functional analysis revealed contrast peaks significantly earlier in the malignant nodes (mean ± standard deviation) of 24.14 ± 2.7 s compared with 29.33 ± 3.4 s (p = 0.0128). Contrast-enhanced ultrasound holds promise in the detection and characterization of metastatic nodes that would not be diagnosed as abnormal on the basis of conventional ultrasound criteria.
National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom. Electronic address: cristinadudau@doctors.org.uk.
Cristina
C
Dudau
National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom.
Shema
S
Hameed
National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom.
Daren
D
Gibson
National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom.
Senthil
S
Muthu
National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom.
Ann
A
Sandison
National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom.
Rob J
RJ
Eckersley
National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom.
Peter
P
Clarke
National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom.
David O
DO
Cosgrove
National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom.
Adrian K
AK
Lim
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D016247:Information Storage and Retrieval / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000077195:Squamous Cell Carcinoma of Head and Neck; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods*
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
Contrast-enhanced ultrasound; Head and neck squamous cell carcinoma; Lymph nodes; Staging