Evaluation of Cervical Lymph Node Enlargement in Patients with Head and Neck Cancer Treated with Radiotherapy by Ultrasonography and CT or MRI
Objective This study was designed to evaluate the diagnostic performance of cervical lymphatic disease(LAP)in patients with head and neck cancer undergoing radiotherapy using ultrasound(US)with/without fine needle aspiration cytology(FNAC)and computed tomography(CT)/magnetic resonance imaging(MRI).Methods 269 patients with head and neck cancer who received radiation therapy(RT)or concurrent chemoradiotherapy(CCRT)between January 2014 and January 2023 were retrospectively analyzed.The diagnostic methods included:(1)CT/MRI alone,(2)ultrasound prediction model after CT/MRI combined with radiotherapy,and(3)CT/MRI combined with US+FNAC.We compared their diagnostic performance using ROC curves.Results A total of 141(52％)malignant and 128(48％)benign lymph nodes were observed.In terms of diagnostic accuracy,combined CT/MRI and US+FNAC had the highest area under the ROC curve(0.965),followed by combined CT/MRI and US prediction model after radiotherapy(0.906)and CT/MRI alone(0.836).Condusion In evaluating LAP in patients with head and neck cancer undergoing radiation therapy,the addition of US examination to CT/MRI has higher diagnostic performance than CT/MRI alone in diagnosing recurrent or persistent nodule disease.
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