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Takashi Nakamura - One of the best experts on this subject based on the ideXlab platform.
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discrimination of metastatic Cervical Lymph Nodes with diffusion weighted mr imaging in patients with head and neck cancer
American Journal of Neuroradiology, 2003Co-Authors: Misa Sumi, Kuniaki Hayashi, Noriyuki Sakihama, Tadateru Sumi, Minoru Morikawa, Masataka Uetani, Hiroyuki Kabasawa, Koichiro Shigeno, Haruo Takahashi, Takashi NakamuraAbstract:BACKGROUND AND PURPOSE: Metastasis to the regional Cervical Lymph Nodes may be associated with alterations in water diffusivity and microcirculation of the node. We tested whether diffusion-weighted MR imaging could discriminate metastatic Nodes. METHODS: Diffusion-weighted echo-planar and T1- and T2-weighted MR imaging sequences were performed on histologically proved metastatic Cervical Lymph Nodes (25 Nodes), benign Lymphadenopathy (25 Nodes), and nodal Lymphomas (five Nodes). The apparent diffusion coefficient (ADC) was calculated by using two b factors (500 and 1000 s/mm2). RESULTS: The ADC was significantly greater in metastatic Lymph Nodes (0.410 ± 0.105 × 10−3 mm2/s, P CONCLUSION: Diffusion-weighted imaging is useful in discriminating metastatic Nodes.
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discrimination of metastatic Cervical Lymph Nodes with diffusion weighted mr imaging in patients with head and neck cancer
American Journal of Neuroradiology, 2003Co-Authors: Misa Sumi, Kuniaki Hayashi, Noriyuki Sakihama, Tadateru Sumi, Minoru Morikawa, Masataka Uetani, Hiroyuki Kabasawa, Koichiro Shigeno, Haruo Takahashi, Takashi NakamuraAbstract:BACKGROUND AND PURPOSE: Metastasis to the regional Cervical Lymph Nodes may be associated with alterations in water diffusivity and microcirculation of the node. We tested whether diffusion-weighted MR imaging could discriminate metastatic Nodes. METHODS: Diffusion-weighted echo-planar and T1- and T2-weighted MR imaging sequences were performed on histologically proved metastatic Cervical Lymph Nodes (25 Nodes), benign Lymphadenopathy (25 Nodes), and nodal Lymphomas (five Nodes). The apparent diffusion coefficient (ADC) was calculated by using two b factors (500 and 1000 s/mm 2 ). RESULTS: The ADC was significantly greater in metastatic Lymph Nodes (0.410 ± 0.105 × 10 −3 mm 2 /s, P −3 mm 2 /s). Nodal Lymphomas showed even lower levels of the ADC (0.223 ± 0.056 × 10 −3 mm 2 /s). ADC criteria for metastatic Nodes (≥ 0.400 × 10 −3 mm 2 /s) yielded a moderate negative predictive value (71%) and high positive predictive value (93%). Receiver operating characteristic analysis demonstrated that the criteria of abnormal signal intensity on T1- or T2-weighted images (A z = 0.8437 ± 0.0230) and ADC (A z = 0.8440 ± 0.0538) provided similar levels of diagnostic ability in differentiating metastatic Nodes. The ADC from metastatic Nodes from highly or moderately differentiated cancers (0.440 ± 0.020 × 10 −3 mm 2 /s, P −3 mm 2 /s). CONCLUSION: Diffusion-weighted imaging is useful in discriminating metastatic Nodes.
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discrimination of metastatic Cervical Lymph Nodes with diffusion weighted mr imaging in patients with head and neck cancer
American Journal of Neuroradiology, 2003Co-Authors: Misa Sumi, Kuniaki Hayashi, Noriyuki Sakihama, Tadateru Sumi, Minoru Morikawa, Masataka Uetani, Hiroyuki Kabasawa, Koichiro Shigeno, Haruo Takahashi, Takashi NakamuraAbstract:BACKGROUND AND PURPOSE: Metastasis to the regional Cervical Lymph Nodes may be associated with alterations in water diffusivity and microcirculation of the node. We tested whether diffusion-weighted MR imaging could discriminate metastatic Nodes. METHODS: Diffusion-weighted echo-planar and T1- and T2-weighted MR imaging sequences were performed on histologically proved metastatic Cervical Lymph Nodes (25 Nodes), benign Lymphadenopathy (25 Nodes), and nodal Lymphomas (five Nodes). The apparent diffusion coefficient (ADC) was calculated by using two b factors (500 and 1000 s/mm 2 ). RESULTS: The ADC was significantly greater in metastatic Lymph Nodes (0.410 ± 0.105 × 10 −3 mm 2 /s, P −3 mm 2 /s). Nodal Lymphomas showed even lower levels of the ADC (0.223 ± 0.056 × 10 −3 mm 2 /s). ADC criteria for metastatic Nodes (≥ 0.400 × 10 −3 mm 2 /s) yielded a moderate negative predictive value (71%) and high positive predictive value (93%). Receiver operating characteristic analysis demonstrated that the criteria of abnormal signal intensity on T1- or T2-weighted images (A z = 0.8437 ± 0.0230) and ADC (A z = 0.8440 ± 0.0538) provided similar levels of diagnostic ability in differentiating metastatic Nodes. The ADC from metastatic Nodes from highly or moderately differentiated cancers (0.440 ± 0.020 × 10 −3 mm 2 /s, P −3 mm 2 /s). CONCLUSION: Diffusion-weighted imaging is useful in discriminating metastatic Nodes.
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comparison of sonography and ct for differentiating benign from malignant Cervical Lymph Nodes in patients with squamous cell carcinoma of the head and neck
American Journal of Roentgenology, 2001Co-Authors: Misa Sumi, Masafumi Ohki, Takashi NakamuraAbstract:OBJECTIVE. We compared the ability of sonography and CT to differentiate benign from malignant Cervical Lymph Nodes in patients with squamous cell carcinoma of the head and neck.MATERIALS AND METHODS. We analyzed 209 Cervical Nodes (102 metastatic and 107 nonmetastatic) from 62 patients with head and neck cancer. These Nodes were topographically correlated by node between images and surgical specimens, and accordingly between sonography and CT.RESULTS. The area under the receiver operating characteristic curve (Az value) for the overall impressions of metastatic or nonmetastatic Nodes was significantly greater for sonography (power Doppler sonography plus gray-scale sonography, 0.97 ± 0.005; gray-scale sonography, 0.95 ± 0.004) than for CT (0.87 ± 0.018). Receiver operating characteristic curve analysis also showed that the greater ability of sonography to depict the internal architecture of the Nodes (Az value, 0.96 ± 0.006) compared with CT (Az value, 0.81 ± 0.027) significantly contributed to the bette...
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multivariate feature analysis of sonographic findings of metastatic Cervical Lymph Nodes contribution of blood flow features revealed by power doppler sonography for predicting metastasis
American Journal of Neuroradiology, 2000Co-Authors: Toru Chikui, Koichi Yonetsu, Takashi NakamuraAbstract:BACKGROUND AND PURPOSE: Sonographic criteria of the Lymph node have been found to be good indicators for metastatic Lymph Nodes. We determined which sonographic features are most predictive of metastasis in Cervical Lymph Nodes among patients with head and neck cancer. METHODS: Gray-scale and power Doppler sonograms were retrospectively analyzed in 133 Cervical Lymph Nodes (57 metastatic and 76 reactive Nodes) from 52 patients with head and neck cancer. The gray-scale sonographic features of the presence or absence of hilar echoes, parenchymal echogenicity, and short and long axis lengths as well as the power Doppler features of normal hilar flow and abnormal parenchymal flow were evaluated. Univariate and multivariate logistic regression analyses were conducted to determine the relative value of each sonographic feature. RESULTS: At univariate analysis, all sonographic features assessed were found to be important. Multivariate analysis, however, suggested that the presence or absence of hilar echoes, increases in short axis length, and the presence of normal hilar flow were the only sonographic features that were predictive of reactive (presence of hilar echoes and hilar flow) and metastatic (increases in short axis length) Lymph Nodes. Although multivariate analysis did not indicate any significant contribution of the color-flow criteria for predicting metastatic Nodes, the color-flow criteria appeared to improve the overall diagnostic accuracy for the less experienced observer. CONCLUSION: The sonographic criteria most predictive of metastatic Cervical Lymph Nodes were absent hilar echoes and increases in short axis length, as assessed by logistic regression analysis. Compared with these gray-scale criteria, color-flow criteria had fewer predictive advantages.
Jung Hwan Baek - One of the best experts on this subject based on the ideXlab platform.
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The diagnostic performance of shear wave elastography for malignant Cervical Lymph Nodes: A systematic review and meta-analysis
European radiology, 2016Co-Authors: Chong Hyun Suh, Young Jun Choi, Jung Hwan Baek, Jeong Hyun LeeAbstract:To evaluate the diagnostic performance of shear wave elastography for malignant Cervical Lymph Nodes. We searched the Ovid-MEDLINE and EMBASE databases for published studies regarding the use of shear wave elastography for diagnosing malignant Cervical Lymph Nodes. The diagnostic performance of shear wave elastography was assessed using bivariate modelling and hierarchical summary receiver operating characteristic modelling. Meta-regression analysis and subgroup analysis according to acoustic radiation force impulse imaging (ARFI) and Supersonic shear imaging (SSI) were also performed. Eight eligible studies which included a total sample size of 481 patients with 647 Cervical Lymph Nodes, were included. Shear wave elastography showed a summary sensitivity of 81 % (95 % CI: 72-88 %) and specificity of 85 % (95 % CI: 70-93 %). The results of meta-regression analysis revealed that the prevalence of malignant Lymph Nodes was a significant factor affecting study heterogeneity (p < .01). According to the subgroup analysis, the summary estimates of the sensitivity and specificity did not differ between ARFI and SSI (p = .93). Shear wave elastography is an acceptable imaging modality for diagnosing malignant Cervical Lymph Nodes. We believe that both ARFI and SSI may have a complementary role for diagnosing malignant Cervical Lymph Nodes. • Shear wave elastography is acceptable modality for diagnosing malignant Cervical Lymph Nodes. • Shear wave elastography demonstrated summary sensitivity of 81 % and specificity of 85 %. • ARFI and SSI have complementary roles for diagnosing malignant Cervical Lymph Nodes.
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virtual touch tissue imaging quantification shear wave elastography prospective assessment of Cervical Lymph Nodes
Ultrasound in Medicine and Biology, 2016Co-Authors: Kai Lun Cheng, Young Jun Choi, Jeong Hyun Lee, Woo Hyun Shim, Jung Hwan BaekAbstract:The goal of this study was to prospectively evaluate the diagnostic performance of Virtual Touch tissue imaging quantification (VTIQ) shear wave elastography in the discrimination of benign and malignant Cervical Lymph Nodes in routine clinical practice. Shear wave velocity was analyzed using VTIQ in 100 patients with 100 histologically proven Cervical Lymph Nodes. Diagnostic performance was evaluated using receiver operating characteristic curve analysis and leave-one-out cross-validation. Agreement between measurements was assessed with intra-class correlation coefficients. The mean shear wave velocity was significantly higher in metastatic Lymphadenopathy (4.46 ± 1.46 m/s) than in benign Lymphadenopathy (2.71 ± 0.85 m/s) (p < 0.001) at a cutoff level of 3.34 m/s. The cross-validated accuracy, sensitivity and specificity were 77%, 78.9% and 74.4%, respectively. Agreement of measurements with VTIQ was excellent (intra-class correlation coefficient = 0.961). VTIQ shear wave elastography may be a feasible quantitative imaging method for differentiating benign and malignant Cervical Lymph Nodes.
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Ultrasound elastography for evaluation of Cervical Lymph Nodes
Ultrasonography, 2015Co-Authors: Young Jun Choi, Jung Hwan BaekAbstract:Ultrasound (US) elastography has been introduced as a noninvasive imaging technique for evaluating Cervical Lymph Nodes. US elastography techniques include strain elastography and shear wave-based elastography. The application of this technique is based on the fact that stiff tissues tend to deform less and show less strain than compliant tissues when the same force is applied. In general, metastatic Lymph Nodes demonstrate higher stiffness than benign Lymph Nodes. Overall, preliminary studies suggest that US elastography may be useful in differentiating benign and malignant Cervical Lymph Nodes, thereby informing decisions to perform a biopsy and facilitating follow-up. For US elastography to be accepted into clinical practice, however, its techniques, associated diagnostic criteria, and reliability need to be further refined.
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quantitative shear wave elastography in the evaluation of metastatic Cervical Lymph Nodes
Ultrasound in Medicine and Biology, 2013Co-Authors: Young Jun Choi, Jeong Hyun Lee, Hyun Lim, Sang Yoon Kim, Myung Woul Han, Kyungja Cho, Jung Hwan BaekAbstract:Our aim was to compare the diagnostic performance of shear wave elastography (SWE) with that of gray-scale ultrasound (US) in differentiating metastatic from benign Lymph Nodes in patients with head and neck malignancies. Maximum shear elasticity modulus (maxSM) was measured on SWE. The reference standard was pathologic diagnosis after surgery. We examined 67 Lymph Nodes (34 metastatic, 33 benign) from 15 patients (8 men and 7 women; mean age, 54.2 years). The maxSM value was significantly higher for metastatic than benign Lymph Nodes (41.06 ± 36.34 kPa vs. 14.22 ± 4.19 kPa, p < 0.0001) at a cutoff level of 19.44 kPa. Accuracy, sensitivity and specificity were 94, 91 and 97%, respectively, for SWE, and 91, 88 and 94%, respectively, for gray-scale US. Multiple regression analysis showed that the maxSM value (r = 0.882) and gray-scale US criteria (r = 0.837) were independent variables. SWE may be a valuable quantitative reproducible method for characterizing Cervical Lymph Nodes.
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diagnostic benefit of thyroglobulin measurement in fine needle aspiration for diagnosing metastatic Cervical Lymph Nodes from papillary thyroid cancer correlations with us features
Korean Journal of Radiology, 2009Co-Authors: Se Jeong Jeon, Jung Hwan Baek, Eunhee Kim, Jeong Seon Park, Kyu Ri Son, Yoon Suk Kim, Do Joon Park, Bo Youn ChoAbstract:Objective: Our goals were to determine the added value of fine-needle aspiration biopsy (FNAB)-thyroglobulin (Tg) measurements over FNAB-cytology alone for diagnosing metastatic Nodes, and to determine whether the ultrasound features of Lymph Nodes can be used to identify Lymph Nodes that may benefit from FNAB-Tg measurement in patients with papillary thyroid cancer. Materials and Methods: We retrospectively evaluated 76 surgically proven Cervical Lymph Nodes. Twenty-nine patients were awaiting surgery and 18 patients had undergone thyroid surgery for papillary thyroid cancer. Ultrasoundguided FNAB and Tg measurements were performed and the ultrasound features were evaluated. Results: The accuracies, sensitivities, and specificities of FNAB-cytology, FNAB-Tg, and combined FNAB-Tg/cytology were 90%, 80%, and 100%; 92%, 95%, and 90%; and 93%, 96%, and 90%, respectively. The diagnostic sensitivity of FNAB-Tg for metastatic Nodes was significantly higher than that of FNAB-cytology (p = 0.011). Furthermore, combined FNAB-Tg/cytology significantly increased sensitivity (p = 0.002) and accuracy (p = 0.03) as compared with FNAB-cytology.
William M Mendenhall - One of the best experts on this subject based on the ideXlab platform.
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diagnostic evaluation of squamous cell carcinoma metastatic to Cervical Lymph Nodes from an unknown head and neck primary site
Laryngoscope, 2009Co-Authors: Marco Cianchetti, Anthony A Mancuso, Robert J Amdur, John W Werning, Jessica Kirwan, Christopher G Morris, William M MendenhallAbstract:Background. The purpose of this study was to evaluate the efficacy of the modern diagnostic evaluation for squamous cell carcinoma metastatic to Cervical Lymph Nodes from an unknown head and neck primary site. Methods. One hundred thirty patients were evaluated be- tween June 1983 and June 1997. All underwent head and neck examinations, head and neck computed tomography (CT), and/or magnetic resonance imaging (MRI) scans, panendoscopies, and biopsies of head and neck mucosal sites. Twenty-four patients underwent 2-(fluorine-18)-2-deoxy-D-glucose (FDG) single pho- ton emission computed tomography (SPECT); 34 patients under- went tonsillectomy. Results. The primary site was identified in 56 patients (43%); the likelihood was increased in patients with suggestive findings on physical examination and/or radiographic evaluation. Eighty- three percent of the lesions were located in the tonsillar fossa and base of tongue. Results of FDG-SPECT scans were positive in 20 patients (83%); the primary tumor was detected in 7 patients (35%). Twelve (35%) of 34 patients who underwent tonsillectomy had a primary tumor discovered in the tonsillar fossa. Multivariate analysis of successful primary site detection revealed that sug- gestive findings on physical examination (p = .0225) and sugges- tive findings on CT and/or MRI (p = .0013) were significantly related to this end point. Conclusion. The primary lesion will be detected in over 40% of patients with physical examination of the head and neck and CT and/or MRI followed by panendoscopy and biopsies. Limited data pertaining to FDG-SPECT suggest that this provides addi- tional useful information in a small subset of patients. Tonsillec- tomy is useful for those with suggestive findings on physical ex- amination and/or radiographic evaluation. © 1998 John Wiley & Sons, Inc. Head Neck 20: 739-744, 1998.
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diagnostic evaluation of squamous cell carcinoma metastatic to Cervical Lymph Nodes from an unknown head and neck primary site
Laryngoscope, 2009Co-Authors: Marco Cianchetti, Anthony A Mancuso, Robert J Amdur, John W Werning, Jessica Kirwan, Christopher G Morris, William M MendenhallAbstract:Background. The purpose of this study was to evaluate the efficacy of the modern diagnostic evaluation for squamous cell carcinoma metastatic to Cervical Lymph Nodes from an unknown head and neck primary site. Methods. One hundred thirty patients were evaluated be- tween June 1983 and June 1997. All underwent head and neck examinations, head and neck computed tomography (CT), and/or magnetic resonance imaging (MRI) scans, panendoscopies, and biopsies of head and neck mucosal sites. Twenty-four patients underwent 2-(fluorine-18)-2-deoxy-D-glucose (FDG) single pho- ton emission computed tomography (SPECT); 34 patients under- went tonsillectomy. Results. The primary site was identified in 56 patients (43%); the likelihood was increased in patients with suggestive findings on physical examination and/or radiographic evaluation. Eighty- three percent of the lesions were located in the tonsillar fossa and base of tongue. Results of FDG-SPECT scans were positive in 20 patients (83%); the primary tumor was detected in 7 patients (35%). Twelve (35%) of 34 patients who underwent tonsillectomy had a primary tumor discovered in the tonsillar fossa. Multivariate analysis of successful primary site detection revealed that sug- gestive findings on physical examination (p = .0225) and sugges- tive findings on CT and/or MRI (p = .0013) were significantly related to this end point. Conclusion. The primary lesion will be detected in over 40% of patients with physical examination of the head and neck and CT and/or MRI followed by panendoscopy and biopsies. Limited data pertaining to FDG-SPECT suggest that this provides addi- tional useful information in a small subset of patients. Tonsillec- tomy is useful for those with suggestive findings on physical ex- amination and/or radiographic evaluation. © 1998 John Wiley & Sons, Inc. Head Neck 20: 739-744, 1998.
Misa Sumi - One of the best experts on this subject based on the ideXlab platform.
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discrimination of metastatic Cervical Lymph Nodes with diffusion weighted mr imaging in patients with head and neck cancer
American Journal of Neuroradiology, 2003Co-Authors: Misa Sumi, Kuniaki Hayashi, Noriyuki Sakihama, Tadateru Sumi, Minoru Morikawa, Masataka Uetani, Hiroyuki Kabasawa, Koichiro Shigeno, Haruo Takahashi, Takashi NakamuraAbstract:BACKGROUND AND PURPOSE: Metastasis to the regional Cervical Lymph Nodes may be associated with alterations in water diffusivity and microcirculation of the node. We tested whether diffusion-weighted MR imaging could discriminate metastatic Nodes. METHODS: Diffusion-weighted echo-planar and T1- and T2-weighted MR imaging sequences were performed on histologically proved metastatic Cervical Lymph Nodes (25 Nodes), benign Lymphadenopathy (25 Nodes), and nodal Lymphomas (five Nodes). The apparent diffusion coefficient (ADC) was calculated by using two b factors (500 and 1000 s/mm2). RESULTS: The ADC was significantly greater in metastatic Lymph Nodes (0.410 ± 0.105 × 10−3 mm2/s, P CONCLUSION: Diffusion-weighted imaging is useful in discriminating metastatic Nodes.
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discrimination of metastatic Cervical Lymph Nodes with diffusion weighted mr imaging in patients with head and neck cancer
American Journal of Neuroradiology, 2003Co-Authors: Misa Sumi, Kuniaki Hayashi, Noriyuki Sakihama, Tadateru Sumi, Minoru Morikawa, Masataka Uetani, Hiroyuki Kabasawa, Koichiro Shigeno, Haruo Takahashi, Takashi NakamuraAbstract:BACKGROUND AND PURPOSE: Metastasis to the regional Cervical Lymph Nodes may be associated with alterations in water diffusivity and microcirculation of the node. We tested whether diffusion-weighted MR imaging could discriminate metastatic Nodes. METHODS: Diffusion-weighted echo-planar and T1- and T2-weighted MR imaging sequences were performed on histologically proved metastatic Cervical Lymph Nodes (25 Nodes), benign Lymphadenopathy (25 Nodes), and nodal Lymphomas (five Nodes). The apparent diffusion coefficient (ADC) was calculated by using two b factors (500 and 1000 s/mm 2 ). RESULTS: The ADC was significantly greater in metastatic Lymph Nodes (0.410 ± 0.105 × 10 −3 mm 2 /s, P −3 mm 2 /s). Nodal Lymphomas showed even lower levels of the ADC (0.223 ± 0.056 × 10 −3 mm 2 /s). ADC criteria for metastatic Nodes (≥ 0.400 × 10 −3 mm 2 /s) yielded a moderate negative predictive value (71%) and high positive predictive value (93%). Receiver operating characteristic analysis demonstrated that the criteria of abnormal signal intensity on T1- or T2-weighted images (A z = 0.8437 ± 0.0230) and ADC (A z = 0.8440 ± 0.0538) provided similar levels of diagnostic ability in differentiating metastatic Nodes. The ADC from metastatic Nodes from highly or moderately differentiated cancers (0.440 ± 0.020 × 10 −3 mm 2 /s, P −3 mm 2 /s). CONCLUSION: Diffusion-weighted imaging is useful in discriminating metastatic Nodes.
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discrimination of metastatic Cervical Lymph Nodes with diffusion weighted mr imaging in patients with head and neck cancer
American Journal of Neuroradiology, 2003Co-Authors: Misa Sumi, Kuniaki Hayashi, Noriyuki Sakihama, Tadateru Sumi, Minoru Morikawa, Masataka Uetani, Hiroyuki Kabasawa, Koichiro Shigeno, Haruo Takahashi, Takashi NakamuraAbstract:BACKGROUND AND PURPOSE: Metastasis to the regional Cervical Lymph Nodes may be associated with alterations in water diffusivity and microcirculation of the node. We tested whether diffusion-weighted MR imaging could discriminate metastatic Nodes. METHODS: Diffusion-weighted echo-planar and T1- and T2-weighted MR imaging sequences were performed on histologically proved metastatic Cervical Lymph Nodes (25 Nodes), benign Lymphadenopathy (25 Nodes), and nodal Lymphomas (five Nodes). The apparent diffusion coefficient (ADC) was calculated by using two b factors (500 and 1000 s/mm 2 ). RESULTS: The ADC was significantly greater in metastatic Lymph Nodes (0.410 ± 0.105 × 10 −3 mm 2 /s, P −3 mm 2 /s). Nodal Lymphomas showed even lower levels of the ADC (0.223 ± 0.056 × 10 −3 mm 2 /s). ADC criteria for metastatic Nodes (≥ 0.400 × 10 −3 mm 2 /s) yielded a moderate negative predictive value (71%) and high positive predictive value (93%). Receiver operating characteristic analysis demonstrated that the criteria of abnormal signal intensity on T1- or T2-weighted images (A z = 0.8437 ± 0.0230) and ADC (A z = 0.8440 ± 0.0538) provided similar levels of diagnostic ability in differentiating metastatic Nodes. The ADC from metastatic Nodes from highly or moderately differentiated cancers (0.440 ± 0.020 × 10 −3 mm 2 /s, P −3 mm 2 /s). CONCLUSION: Diffusion-weighted imaging is useful in discriminating metastatic Nodes.
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comparison of sonography and ct for differentiating benign from malignant Cervical Lymph Nodes in patients with squamous cell carcinoma of the head and neck
American Journal of Roentgenology, 2001Co-Authors: Misa Sumi, Masafumi Ohki, Takashi NakamuraAbstract:OBJECTIVE. We compared the ability of sonography and CT to differentiate benign from malignant Cervical Lymph Nodes in patients with squamous cell carcinoma of the head and neck.MATERIALS AND METHODS. We analyzed 209 Cervical Nodes (102 metastatic and 107 nonmetastatic) from 62 patients with head and neck cancer. These Nodes were topographically correlated by node between images and surgical specimens, and accordingly between sonography and CT.RESULTS. The area under the receiver operating characteristic curve (Az value) for the overall impressions of metastatic or nonmetastatic Nodes was significantly greater for sonography (power Doppler sonography plus gray-scale sonography, 0.97 ± 0.005; gray-scale sonography, 0.95 ± 0.004) than for CT (0.87 ± 0.018). Receiver operating characteristic curve analysis also showed that the greater ability of sonography to depict the internal architecture of the Nodes (Az value, 0.96 ± 0.006) compared with CT (Az value, 0.81 ± 0.027) significantly contributed to the bette...
Anil T. Ahuja - One of the best experts on this subject based on the ideXlab platform.
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shear wave elasticity imaging of Cervical Lymph Nodes
Ultrasound in Medicine and Biology, 2012Co-Authors: Kunwar S S Bhatia, Carmen C M Cho, Cina S L Tong, Edmund H Y Yuen, Anil T. AhujaAbstract:A pilot study of real-time shear wave ultrasound elastography (SWE) for Cervical Lymphadenopathy in routine clinical practice was conducted on 55 Nodes undergoing conventional ultrasound (US) with US-guided needle aspiration for cytology. Elastic moduli of stiffest regions in Nodes were measured on colour-coded elastograms, which were correlated with cytology. Malignant Nodes (n = 31, 56.4%) were stiffer (median 25.0 kPa, range 6.9-278.9 kPa) than benign Nodes (median 21.4 kPa, range 8.9-30.2 kPa) (p = 0.008, Mann Whitney U test). A cut-off of 30.2 kPa attained highest accuracy of 61.8%, corresponding to 41.9% sensitivity, 100% specificity and 0.77 area under the receiver operating characteristic curve. Qualitatively, elastograms of benign Nodes were homogeneously soft; malignant Nodes were homogeneously soft or markedly heterogeneous with some including regions lacking elasticity signal. SWE is feasible for neck Nodes. It appears unsuitable for cancer screening but may detect a subset of malignant Nodes. The cause of spatial heterogeneity of malignant Nodes on SWE is yet to be established.
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ultrasound of malignant Cervical Lymph Nodes
Cancer Imaging, 2008Co-Authors: Anil T. Ahuja, Michael Ying, Gregory E Antonio, Yolanda Y P Lee, Ann D King, K T WongAbstract:Malignant Lymph Nodes in the neck include metastases and Lymphoma. Cervical nodal metastases are common in patients with head and neck cancers, and their assessment is important as it affects treatment planning and prognosis. Neck Nodes are also a common site of Lymphomatous involvement and an accurate diagnosis is essential as its treatment differs from other causes of neck Lymphadenopathy. On ultrasound, grey scale sonography helps to evaluate nodal morphology, whilst power Doppler sonography is used to assess the vascular pattern. Grey scale sonographic features that help to identify metastatic and Lymphomatous Lymph Nodes include size, shape and internal architecture (loss of hilar architecture, presence of intranodal necrosis and calcification). Soft tissue oedema and nodal matting are additional grey scale features seen in tuberculous Nodes or in Nodes that have been previously irradiated. Power Doppler sonography evaluates the vascular pattern of Nodes and helps to identify the malignant Nodes. In addition, serial monitoring of nodal size and vascularity are useful features in the assessment of treatment response.
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sonographic evaluation of Cervical Lymph Nodes
American Journal of Roentgenology, 2005Co-Authors: Anil T. Ahuja, Michael YingAbstract:OBJECTIVE. Sonography is a useful imaging tool in the evaluation of Cervical Lymph Nodes. Gray-scale sonography and color and power Doppler sonography are commonly used in clinical practice. This article documents the common sonographic appearances of different causes of Cervical Lymphadenopathy.CONCLUSION. The sonographic appearances of normal Nodes differ from those of abnormal Nodes. Sonographic features that help to identify abnormal Nodes include shape (round), absent hilus, intranodal necrosis, reticulation, calcification, matting, soft-tissue edema, and peripheral vascularity.
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sonographic evaluation of Cervical Lymph Nodes
American Journal of Roentgenology, 2005Co-Authors: Anil T. Ahuja, Michael YingAbstract:OBJECTIVE. Sonography is a useful imaging tool in the evaluation of Cervical Lymph Nodes. Gray-scale sonography and color and power Doppler sonography are commonly used in clinical practice. This article documents the common sonographic appearances of different causes of Cervical Lymphadenopathy.CONCLUSION. The sonographic appearances of normal Nodes differ from those of abnormal Nodes. Sonographic features that help to identify abnormal Nodes include shape (round), absent hilus, intranodal necrosis, reticulation, calcification, matting, soft-tissue edema, and peripheral vascularity.