Ontology highlight
ABSTRACT: Background
Accurate staging of cervical lymph nodes (LN) is pivotal for further clinical management of patients with head and neck cancer. Functional magnetic resonance imaging (MRI) such as three-dimensional (3D) dynamic contrast-enhanced (DCE) acquisition might improve the diagnosis of cervical LN metastases.Purpose
To evaluate the additional diagnostic value of high-resolution 3D T1-weighted DCE in detecting LN metastasis compared to standard morphological imaging criteria in patients with head and neck tumors as correlated to histopathology.Material and methods
Standard MRI with 3D DCE acquisition at voxel sizes of 1 × 1×1 mm was performed in 15 patients before surgery; 92 LN of the head and neck were histopathologically analyzed. A logistic regression analysis of semi-quantitative DCE parameters, time-intensity curve (TIC) shapes, and morphological criteria was performed to differentiate benign from malignant LN.Results
Standard MRI was sufficient for diagnosis of malignancy in LN with a short-axis diameter ≥ 15 mm (n = 17). For LN metastases with a short-axis diameter <15 mm (n = 12), however, the combination of 3D DCE MRI parameters, TIC shapes, and LN diameter significantly increased the sensitivity and specificity of diagnosing metastases (DCE + TIC shape + LN diameter: 92% and 88% vs. DCE only: 83% and 68% (P < 0.01) vs. LN diameter only: 83% and 77% (P = 0.04).Conclusion
MRI including isotropic high-resolution 3D DCE acquisition combined with morphological criteria allows an accurate assessment of small cervical LN metastases in patients with head and neck cancer. For LN ≥ 15 mm diameter, morphologic imaging may suffice to diagnose metastatic disease to the LN.
SUBMITTER: Treutlein C
PROVIDER: S-EPMC7453466 | biostudies-literature | 2020 Aug
REPOSITORIES: biostudies-literature
Treutlein Christoph C Stollberg Adrian A Scherl Claudia C Agaimy Abbas A Ellmann Stephan S Iro Heinrich H Lell Michael M Uder Michael M Bäuerle Tobias T
Acta radiologica open 20200826 8
<h4>Background</h4>Accurate staging of cervical lymph nodes (LN) is pivotal for further clinical management of patients with head and neck cancer. Functional magnetic resonance imaging (MRI) such as three-dimensional (3D) dynamic contrast-enhanced (DCE) acquisition might improve the diagnosis of cervical LN metastases.<h4>Purpose</h4>To evaluate the additional diagnostic value of high-resolution 3D T1-weighted DCE in detecting LN metastasis compared to standard morphological imaging criteria in ...[more]