Department of Head & Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Oral Oncol. 2013 Jun;49(6):626-33. doi: 10.1016/j.oraloncology.2013.02.010. Epub 2013 Mar 20.
The aim of this study is to determine a set of MRI lymph node characteristics predictive for extranodal tumor spread (ENS) in head and neck cancer patients.
In 39 patients, 60 lymph nodes with on MRI a minimal axial diameter of more than 1cm or an inhomogeneous enhancement were studied. Two radiologists evaluated all MR-images for findings potentially indicative of the presence of ENS. Sensitivity, specificity and odds ratios based on logistic regression were calculated.
On MR-imaging, 20 lymph nodes were staged positive for ENS. On histopathology, 30 nodes were positive for ENS. In total, 14 nodes (23%) were scored differently on MR-imaging and histopathology. The MR-finding "infiltration of adjacent planes" established a specificity of 100% (lower 90% confidence bound: 91%) and sensitivity of 50% (95% confidence interval [CI]: 28-72%).
The MRI finding "infiltration of adjacent planes" may be high enough (100% in our study) to be used for treatment planning.
本研究旨在确定一组可预测头颈部癌症患者淋巴结外肿瘤扩散（ENS）的 MRI 淋巴结特征。
在 39 名患者中，对 60 个在 MRI 上具有最小轴径大于 1cm 或不均匀增强的淋巴结进行了研究。两位放射科医生评估了所有 MRI 图像中可能提示 ENS 存在的发现。基于逻辑回归计算了敏感性、特异性和优势比。
在 MRI 成像上，20 个淋巴结被分期为 ENS 阳性。在组织病理学上，30 个淋巴结 ENS 阳性。总共，14 个淋巴结（23%）在 MRI 成像和组织病理学上的评分不同。MRI 发现“邻近平面浸润”的特异性为 100%（90%置信区间下限：91%），敏感性为 50%（95%置信区间：28-72%）。
在我们的研究中，MRI 发现“邻近平面浸润”的特异性可能足够高（100%），可用于治疗计划。
