Abstract
Background
The most important prognostic factor in squamous cell carcinoma of the head and neck (HNSCC) is the presence or absence of clinically involved neck nodes. The presence of metastases in a lymph node is said to reduce the 5-years survival rate by about 50%. The appropriate diagnosis of the presence of metastatic node is very important for the management of HNSCC
Aim
To compare difTerent diagnostic modalities for assessment of the clinically non palpable lymph nodes in HNSCC including by meta-analysis: CT, MRI, US, USFNAC and PET/CT for the proper cervical lymph node staging.
Methods
Met-analysis study on patients with HNSCC of clinically non palpable lymph nodes (cN0).
Results
Analysis was divided in 6 groups .Each group contain analysis of one modality according to available studies per patient, per level and per lesion .US is fair test per patient and per lesion.CT is good test per patient and excellent test per lesion.MRI is poor test per patient and fair test per lesion.CT-MRl combined is fair per patient and excellent per level.PET/CT is good per patient, fair per lesion and excellent per level. USFNAC is excellent per lesion.
Conclusion
CT, CT-MRI combined, PET/CT and USFNAC proved to be excellent in detecting cN0.MRI was poor test in detecting cN0.US was a fair test in detecting cN0 if used alone.
Diagnostic accuracy and additional value of diffusion-weighted imaging for discrimination of malignant cervical lymph nodes in head and neck squamous cell carcinoma
