ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2020
vol. 85
 
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Head and neck radiology
abstract:
Original paper

Diagnostic ability of contrast-enhanced computed tomography for metastatic cervical nodes in head and neck squamous cell carcinomas: significance of additional coronal reconstruction images

Tomohiro Ando
,
Hiroki Kato
,
Masaya Kawaguchi
,
Yukichi Tanahashi
,
Mitsuhiro Aoki
,
Bunya Kuze
,
Masayuki Matsuo

© Pol J Radiol 2020; 84: e1-e7
Online publish date: 2020/01/06
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Purpose
To evaluate the significance of additional coronal reconstruction images in the diagnostic ability of contrast- enhanced computed tomography (CECT) for metastatic cervical nodes in patients with head and neck squamous cell carcinomas (HNSCC).

Material and methods
We retrospectively assessed 97 metastatic and 141 reactive histologically proven cervical nodes of 38 patients with HNSCC, who underwent CECT before neck dissection. Observer #1, an expert radiologist in head and neck imaging, and observer #2, a general radiologist, reviewed all CECT images. The observers first assessed the presence of nodal metastasis using axial CECT alone (A-CECT). Three days later, they reassessed its presence using combined axial and coronal CECT (A&C-CECT).

Results
The sensitivity of A-CECT vs. A&C-CECT was 73.2% vs. 75.3% for observer #1 (p = 0.73) and 69.1% vs. 69.1% for observer #2 (p = 1.00), respectively. The specificity of A-CECT versus A&C-CECT was 92.2% vs. 97.2% for observer #1 (p < 0.05) and 92.9% vs. 95.7% for observer #2 (p = 0.22), respectively. The accuracy of A-CECT versus A&C-CECT was 84.5% vs. 88.2% for observer #1 (p < 0.05) and 83.2% vs. 85.3% for observer #2 (p = 0.30), respectively. The area under the curve (AUC) of A-CECT vs. A&C-CECT was 0.86 vs. 0.91 for observer #1 (p < 0.05) and 0.85 vs. 0.85 for observer #2 (p = 0.80), respectively.

Conclusions
The specificity, accuracy, and AUC increased with the use of coronal images during the assessment by the expert radiologist. The appropriate use of coronal images allowed proper configuration recognition and improved diagnostic ability.

keywords:

head and neck squamous cell carcinomas, lymph node metastasis, CT, coronal reconstruction images

 
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