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Sensitivity and specificity of computed tomography for detection of extranodal spread from metastatic head and neck squamous cell carcinoma

Published online by Cambridge University Press:  12 January 2009

M A Souter ,
R S Allison ,
J H Clarkson ,
I A Cowan ,
M H Coates  and
J E Wells
M A Souter*
Affiliation:
Department of Otolaryngology Head Neck Surgery, Christchurch Hospital, Christchurch, New Zealand
R S Allison
Affiliation:
Department of Otolaryngology Head Neck Surgery, Christchurch Hospital, Christchurch, New Zealand
J H Clarkson
Affiliation:
Department of Otolaryngology Head Neck Surgery, Christchurch Hospital, Christchurch, New Zealand
I A Cowan
Affiliation:
Department of Radiology, Christchurch Hospital, Christchurch, New Zealand
M H Coates
Affiliation:
Department of Radiology, Christchurch Hospital, Christchurch, New Zealand
J E Wells
Affiliation:
Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand
*
Address for correspondence: Dr Melanie Souter, c/o 32 Rata Street, Riccarton, Christchurch 8041, New Zealand. Fax: +64 9 4196975 E-mail: drmelaniesouter@paradise.net.nz
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Abstract

Aim:

To estimate the sensitivity and specificity of computed tomography used for the detection of extranodal spread of metastatic head and neck squamous cell carcinoma, by experienced head and neck radiologists.

Materials and methods:

Participants had undergone a neck dissection for head and neck squamous cell carcinoma, together with computed tomography scanning prior to surgery (accessible for reporting). Computed tomography images were independently examined by two experienced head and neck radiologists. Nodal involvement by squamous cell carcinoma and the presence or absence of extranodal spread were recorded. Results were compared to the histological specimen. The sensitivity, specificity and positive predictive value of using computed tomography for the detection of nodal involvement and presence or absence of extranodal spread were estimated, and 95 per cent confidence intervals were calculated.

Results and analysis:

The study analysed 149 neck dissections. When using computed tomography to detect the extranodal spread of head and neck squamous cell carcinoma, radiologists A and B had sensitivities of 66 and 80 per cent, specificities of 91 and 90 per cent, and positive predictive values of 85 and 87 per cent, respectively.

Discussion:

The sensitivity and specificity of radiological detection of extranodal spread from head and neck squamous cell carcinoma is not well reported in the literature. Accuracy of reporting improves in the hands of experienced head and neck radiologists. This finding has clinical implications for surgical planning and adjuvant therapy requirements.

Keywords

Carcinoma, Squamous CellHead and Neck NeoplasmsSensitivity and SpecificityNeoplasm Metastasis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 7 , July 2009 , pp. 778 - 782
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the New Zealand Society of Otolaryngology Head and Neck Surgery Annual Scientific Meeting, 31 October – 3 November 2006, Timaru, New Zealand.

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