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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleHead and Neck Imaging

Lymph Nodes of Patients with Regional Metastases from Head and Neck Squamous Cell Carcinoma as a Predictor of Pathologic Outcome: Size Changes at CT before and after Radiation Therapy

Hiroya Ojiri, Anthony A. Mancuso, William M. Mendenhall and Scott P. Stringer
American Journal of Neuroradiology November 2002, 23 (10) 1627-1631;
Hiroya Ojiri
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Anthony A. Mancuso
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William M. Mendenhall
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Scott P. Stringer
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Article Figures & Data

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    Fig 1.

    Images in a 46-year-old man with a carcinoma at the base of his tongue (T4N3[3, 3]). (The percentage decrease ratio was calculated as in follows: % decrease ratio = (1 - b/a) × 100, where a and b are the dimensions shown in images A and B, respectively.

    A, Pre-RT contrast-enhanced CT image reveals enlarged level 2 lymph nodes (N) on both sides. The one on the right measures 54 × 33 mm, and that on the left, 57 × 45 mm. The nodes contain focal areas of low attenuation. An infiltrative mass involves the lower part of the base of the tongue.

    B, Post-RT contrast-enhanced CT image shows a marked decrease in the size of the lymph nodes. The decrease ratio of the largest dimension of the nodes is 59% on the right and 51% on the left. The patient underwent planned post-RT neck dissection on both sides. The surgical specimens were negative on both sides.

  • Fig 2.
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    Fig 2.

    Images in a 64-year-old man with metastatic neck disease from an unknown primary squamous cell carcinoma (TXN2A).

    A, Pre-RT contrast-enhanced CT image reveals an enlarged (27 × 22 mm) level 2 lymph node (N) on the left.

    B, Post-RT contrast-enhanced CT image shows a small residual mass (arrow) (decrease ratio of the largest dimension of the node, 52%). The patient underwent left neck dissection after this study. The specimen from the left hemineck was negative.

  • Fig 3.
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    Fig 3.

    Images in a 52-year-old man with tongue base carcinoma (T2N2B).

    A, Pre-RT contrast-enhanced CT image shows the enlarged (34 × 24 mm) level 2 lymph node (N) on the right. The node contains a focal area of low attenuation.

    B, Post-RT contrast-enhanced CT image reveals a minimal decrease in the size of the lymph node (decrease ratio of the largest dimension of the node, 6%). The surgical specimen from planned post-RT neck dissection at level 2 of the right hemineck was positive.

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    Fig 4.

    Images in a 78-year-old woman with pyriform sinus carcinoma (T2N2A).

    A, Pre-RT contrast enhanced CT image shows an enlarged (40 × 25 mm) level 4 lymph node (N) on the right. The nodal mass distorts the adjacent right internal jugular vein (J).

    B, Post-RT contrast-enhanced CT image shows a slight increase in the size of the lymph node (decrease ratio of the largest dimension, −20%). The internal attenuation is generally lower on this image than on the image in A. The specimen from the right hemineck was positive.

Tables

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    TABLE 1:

    Number of heminecks in each primary site, and T- and N-stages

    CharacteristicNo. of Heminecks (N = 37)
    Primary site
     Oral cavity2
     Oropharynx22
     Hypopharynx3
     Larynx4
     Unknown6
    T stage
     T06
     T18
     T213
     T33
     T47
    N stage
     N00
     N11
     N2A8
     N2B19
     N39
    • View popup
    TABLE 2:

    Largest axial dimension of the largest node in the 37 heminecks on pre- and post-RT CT scans

    Largest Dimension, mmNo. of Heminecks
    On Pre-RT CT ScansOn Post-RT CT Scans
    <19014
    20–291418
    30–39102
    40–4973
    >5060
    • View popup
    TABLE 3:

    Pathologic outcome and percentage decrease ratio in the largest axial dimension of the largest node in each hemineck

    Decrease Ratio, %No. of Negative Specimens (n = 24)No. of Positive Specimens (n = 13)Total (N = 37)
    <304610
    31–40639
    41–508412
    >50606
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American Journal of Neuroradiology: 23 (10)
American Journal of Neuroradiology
Vol. 23, Issue 10
1 Nov 2002
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Lymph Nodes of Patients with Regional Metastases from Head and Neck Squamous Cell Carcinoma as a Predictor of Pathologic Outcome: Size Changes at CT before and after Radiation Therapy
Hiroya Ojiri, Anthony A. Mancuso, William M. Mendenhall, Scott P. Stringer
American Journal of Neuroradiology Nov 2002, 23 (10) 1627-1631;
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Cite this article
Hiroya Ojiri, Anthony A. Mancuso, William M. Mendenhall, Scott P. Stringer
Lymph Nodes of Patients with Regional Metastases from Head and Neck Squamous Cell Carcinoma as a Predictor of Pathologic Outcome: Size Changes at CT before and after Radiation Therapy
American Journal of Neuroradiology Nov 2002, 23 (10) 1627-1631;

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