Contrast-Enhanced Computed Tomography (CT) With Concordant Sonography as Sufficient Early Detection Tools for Recurrent and Persistent Cervical Metastases After (Chemo)radiotherapy (CRT).

Abstract

Background: Most challenging treatment needs are in recurrent or persisting head and neck squamous cell carcinoma (HNSCC) patients after (((chemo-)radiotherapy) (C)RT).

Materials and methods: This 10-year retrospective study included 100 patients, who initially received (C)RT followed by neck dissection (ND). The results of computed tomography (CT) and sonography were evaluated for residual/recurrent cervical lymph nodes and compared to the histopathology. On this basis we calculate the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV).

Results: A total of 144 ND specimens were analyzed. The combination of CT and sonography (n = 103) reached values 97% sensitivity, 71% specificity, 98% NPV, 66% PPV, and 81% overall accuracy. For patients who received as primary treatment CRT the values for the combined imaging were: 100.0%, 73.5%, 100.0%, 66.7% and 82.7% respectively.

Conclusion: Our study demonstrates that the combined use of CT and sonography reliably detects lymph node metastases, particularly in patients previously treated with CRT, even after a long time after treatment.