Imaging of Lymph Nodes in the Head and Neck Region

Abstract

This paper describes the modern imaging methods, techniques, ability and performance in detecting and staging head and neck lymph nodes. Furthermore, the imaging morphologies of benign and malignant lymph nodes according to the different imaging techniques are shown. The imaging techniques of ultrasonography, computed tomography and magnetic resonance imaging (MRI) including diffusion-weighted imaging and contrast-enhanced iron oxide MRI are explained. Imaging examples of the different modalities of benign- and malignant-transformed lymph nodes are shown. Additionally, the diagnostic sensitivity of each modality are delineated and further aspects of modern lymph node staging of the head and neck region, such as those with special contrast agents are described. These modern imaging modalities have sensitivity rates of 70–80% depending on the technical equipment and ability and on the experience of the investigator. The value of biopsy techniques including recently developed ultrasonography guided needle biopsy with molecular analysis of the cells of about 97–100% accuracy in diagnosing benign from malignant lymph nodes are mentioned. Overall, the reader gets an overview of the present imaging modalities to potentially stage correctly lymph nodes in the head and neck region to facilitate the therapeutic procedure.