Initial staging of the neck in head and neck squamous cell carcinoma: A comparison of CT, PET/CT, and ultrasound-guided fine-needle aspiration cytology

Publication

Initial staging of the neck in head and neck squamous cell carcinoma: A comparison of CT, PET/CT, and ultrasound-guided fine-needle aspiration cytology

Journal Paper/Review - May 20, 2011

Stöckli Sandro, Haerle Stephan K, Strobel Klaus, Haile Sarah, Hany Thomas F, Schuknecht Bernhard

Citation

Stöckli S, Haerle S, Strobel K, Haile S, Hany T, Schuknecht B. Initial staging of the neck in head and neck squamous cell carcinoma: A comparison of CT, PET/CT, and ultrasound-guided fine-needle aspiration cytology. Head & neck 2011; 34:469-76.

Type

Journal Paper/Review (English)

Journal

Head & neck 2011; 34

Publication Date

May 20, 2011

Issn Electronic

1097-0347

Pages

469-76

Brief description/objective

BACKGROUND
The aim of this study was to compare imaging modalities for staging the neck in a prospective cohort of patients evaluated by CT, ultrasound with fine-needle aspiration cytology (FNAC), and [(18) F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT with the histologic evaluation of the neck dissection as the standard of reference.

METHODS
In all, 76 consecutive patients were prospectively enrolled.

RESULTS
Ultrasound-guided FNAC showed the highest level of agreement with histology for exact N classification. Ultrasound-guided FNAC showed the smallest percentage of overstaged patients, 7%, versus 16% with PET/CT, 13% with CT, and 13% with ultrasound. The rate of understaged patients was comparable between the imaging modalities. With regard to the endpoint N0 versus N+ there were no statistically significant differences to be found.

CONCLUSIONS
Ultrasound-guided FNAC seems to correlate best with histologic staging compared with PET/CT and CT. None of the modality is reliable enough to replace elective neck treatment in cN0 necks. © 2011 Wiley Periodicals, Inc. Head Neck, 2012.