Hiroji Nagata RT, Presenter: Nothing to Disclose

Osamu Yamasita RT, Abstract Co-Author: Nothing to Disclose

Masahiro kawasima RT, Abstract Co-Author: Nothing to Disclose

Hiroyuki Tuji MD, Abstract Co-Author: Nothing to Disclose

Munetaka Matoba MD, Abstract Co-Author: Nothing to Disclose

Hisao Tonami MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to evaluate the usefulness of adaptive 4D volume perfusion CT covering the whole-neck in patients with head and neck squamous cell carcinoma (HNSCC) for differentiation between metastatic and non-metastatic cervical lymph nodes.  

Perfusion CT was performed from the level of skull base to thoracic inlet in 25 patients with HNSCC before treatment. Each perfusion CT was performed in 75 seconds and included 15 repeated dynamic CT scan obtained using the adaptive 4D spiral mode. In each patient, perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface product (PS) were calculated for all cervical lymph nodes larger than 8 mm in short axis using dedicated software. Patients underwent tumor resection along with neck dissection or chemoradiotherapy. After chemoradiotherapy, persistent lymphadenopathy were performed either neck dissection or fine needle aspiration. Then, perfusion parameters were correlated with histologic or imaging analysis of lymph nodes

The perfusion parameters and 58 nodes diagnosed as metastasis or non-metastasis by histologic or imaging assessment were correlated. Twenty-six of them were metastatic and the remains were non-metastatic. BF, MTT, and PS of metastatic nodes showed significantly higher than those of non-metastatic nodes (p=0.005, 0.04, and 0.01, respectively). In univariate analysis, BF and PS showed significant association with metastatic nodes (p=0.006, and 0.02, respectively). In multivariate analysis, only BF was identified as a significant parameter associating with metastatic nodes (p=0.03). In receiver operating characteristic analysis, a feasible threshold vale of BF for distinguishing metastatic nodes from non-metastatic nodes revealed a sensitivity of 76.2%, specificity of 72.5%, positive predictive value of 66.7%, and negative predictive value of 80.8%, respectively. 

Adaptive 4D volume perfusion CT covering the whole-neck in patients with HNSCC may be useful for differentiation between metastatic and non-metastatic cervical lymph nodes.

Adaptive 4D volume perfusion CT covering the whole-neck in head and neck squamous cell carcinoma patients may be useful for differentiation between metastatic and non-metastatic cervical lymph nodes. 

Nagata, H, Yamasita, O, kawasima, M, Tuji, H, Matoba, M, Tonami, H, Evaluation of Metastatic Cervical Lymph Nodes Using Adaptive 4D Volume Perfusion CT in Patients with Head and Neck Squamous Cell Carcinoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005952.html