Diagnosis Of Cervical Metastasis Research Articles

Value of18F-Fluorodeoxyglucose Position Emission Tomography/Computed Tomography in Diagnosis of Cervical Lymph Node Metastasis of Head and Neck Squamous Cell Carcinoma: Comparison with Computed Tomography and Magnetic Resonance Imaging

Received January 31, 2012 Revised April 17, 2012 Accepted May 9, 2012 Address for correspondence Kyung Tae, MD Departments of OtolaryngologyHead and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-792, Korea Tel +82-2-2290-8585 Fax +82-2-2293-3335 E-mail kytae@hanyang.ac.kr Background and ObjectivesZZCervical lymph node metastasis is a very important prognostic factor of head and neck squamous cell carcinoma (HNSCC). Therefore, strict evaluation of cervical lymph node metastasis is necessary for accurate staging and proper treatment planning. This study compares computed tomography (CT) and magnetic resonance imaging (MRI) to position emission tomography-computed tomography (PET-CT), and evaluates the clinical role of PET-CT in the diagnosis of cervical metastasis of HNSCC. Subjects and MethodZZFrom October 2004 to September 2010, we studied 74 patients with HNSCC who underwent PET-CT, CT and MRI before undergoing neck dissection for the treatment of cervical lymph node metastasis. We compared pathologic results of 374 cervical lymph node levels in 74 patients with results of PET-CT, CT and MRI. We analyzed and compared sensitivity, specificity, predictability and accuracy of the three imaging methods. ResultsZZAmong the 74 patients, 49 (66.2%) patients had positive cervical lymph node metastasis. Of the 374 cervical lymph node levels, 86 levels were confirmed to be positive lymph node metastasis. Sensitivity and specificity of PET-CT was 87.4% and 94.8% when the cut-off value of SUVmax was 1.855. Sensitivity, specificity, positive and negative predictive value and accuracy of PET-CT were higher than those of CT or MRI. ConclusionZZPET-CT is more effective than CT or MRI in the diagnosis of cervical lymph node metastasis of HNSCC. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:364-8

Uso da ultra-sonografia no diagnóstico e seguimento do carcinoma bem diferenciado da tireóide

Thyroid nodules are found in the vast majority of the population, but only 5 to 10% are malignant. Ultrasonography of the thyroid, by virtue of being a straightforward, non-invasive method presenting strong correlation with macroscopic aspects of the thyroid gland, is being increasingly used to identify nodules that present a higher risk of malignancy. The presence of certain ultrasonographic characteristics such as hypoechogenicity, microcalcifications, irregular contours and central vascularization on Doppler, increase the risk of the lesion being malignant. Conversely, nodules presenting benign ultrasonographic characteristics such as hyperechogenicity and a mixed sponge-like aspect, and a concordant cytology, have a negative predictive value of 96.6%. It is, thus, important to examine all nodular lesions and to identify suspicious lesions that need biopsy, especially in multinodular glands. Ultrasonography is also highly sensitive in the identification of suspicious cervical lymph nodes during the follow-up of patients with thyroid carcinoma, even when PCI is negative and serum thyroglobulin (Tg) levels are undetectable. Tg measurement in the needle wash-out content is recommended as this has proven to be more sensitive than cytology in the diagnosis of cervical metastasis, especially where there is liquid content, and it is not affected by the presence of anti-Tg antibodies.

Epithelial tumors metastatic to the uterine cervix. A study of 33 cases and review of the literature.

Thirty-three cases of true distant metastasis to the uterine cervix from primary tumors in extragenital or intragenital sites have been studied. The group comprised 12 ovarian tumors, 10 colonic tumors, 5 gastric tumors, 4 mammary tumors, 1 renal cell carcinoma, and 1 transitional cell carcinoma of the renal pelvis. Data of mode of presentation, interval between diagnosis of primary tumor and diagnosis of cervical metastasis, and subsequent survival are presented. The literature is reviewed with consideration of the problems of clinical and pathologic diagnosis.