Regional metastasis in head and neck squamous cell carcinoma: revised value of US with US-guided FNAB.

Authors:
  • PKP Knegt
    P Knegt
  • JMJ J Manni
    J J Manni
  • CMC A Meeuwis
    C A Meeuwis
  • HMH A Marres
    H A Marres
  • HSH A Spoelstra
    H A Spoelstra
  • MBM F de Boer
    M F de Boer
  • IBI Bruaset
    I Bruaset
  • JOJ A van Oostayen
    J A van Oostayen
  • JLJ S Laméris
    J S Laméris
  • RKR H Kruyt
    R H Kruyt
  • FJF B Joosten
    F B Joosten
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Abstract
To verify the acclaimed accuracy of ultrasound (US) combined with US-guided fine-needle aspiration biopsy (FNAB) in the detection of lymph node metastasis in the neck and to evaluate the interobserver variability. In a prospective, multicenter study of 185 patients with head and neck squamous cell carcinoma, US (n=238 neck sides) with US-guided FNAB (n=178 neck sides) was used for evaluation of the lymph node status of the neck. Findings were correlated with those of histopathologic examination in 238 neck sides. US with US-guided FNAB had a sensitivity of 77% and a specificity of 100%. Nineteen of 178 aspirations were nondiagnostic. There were no significant differences between the four participating hospitals or the individual sonologists (P>.05). Sensitivity of US with US-guided FNAB was slightly lower compared with previous reports. Specificity was similar to previous reports. Interobserver variability appeared to be low. The validity of US with US-guided FNAB is high and warrants widespread use of the procedure for evaluation of the neck.