Cervical ultrasonography for preoperative T assessment and patient-level detection of cervical nodal metastasis in pharyngeal and laryngeal squamous cell carcinoma: comparison with contrast-enhanced CT and MRI using pathological findings as the reference standard.

Background

Cervical ultrasonography (US) may complement cross-sectional imaging for nodal assessment in pharyngeal and laryngeal squamous cell carcinoma. AIMS/

Objectives

To compare US with contrast-enhanced CT and MRI for patient-level detection of cervical nodal metastasis using pathology as the reference standard; T-staging performance was secondary. MATERIAL AND

Methods

This retrospective study included 107 surgically treated patients. CT and MRI were reassessed by two pathology-blinded radiologists, whereas US classifications were extracted from clinical reports. Nodal performance was evaluated in 72 patients with neck dissection.

Results

For N-positive disease, US sensitivity, specificity, and accuracy were 81.2%, 79.2%, and 80.6%. In the matched N cohort (n = 41), correct classification rates were 82.9%, 80.5%, and 90.2% for US, CT, and MRI (p = 0.395). US primary-tumour assessment was evaluable in 54 of 107 patients (50.5%); sensitivity, specificity, and accuracy for T3-4 disease were 45.5%, 90.5%, and 63.0%. In the matched T cohort (n = 30), correct classification rates were 56.7%, 80.0%, and 76.7% (p = 0.028); no pairwise comparison remained significant after Holm adjustment.

Conclusions

AND

Significance

US may complement assessment of accessible cervical nodes, but primary-tumour applicability is limited. CT and MRI remain essential for assessment of primary-tumour extent and deep nodal disease.