Detection of suspicious malignant cervical lymph nodes of unknown origin

Diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy with nodal size and central necrosis correlate

Chung Ping Lo, Cheng Yu Chen, Shy Chyi Chin, Kwo Whei Lee, Chun Jen Hsueh, Chun Jung Juan, Hung Wen Kao, Guo Shu Huang

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: To assess the role of ultrasound-guided fine-needle aspiration biopsy (US-guided FNAB) in the diagnostic workup of suspicious malignant cervical lymph nodes in patients with palpable neck masses and without known primary cancer. The diagnostic accuracy of imaging morphologic criteria, including sizes and central necrosis for assessing suspicious malignant nodes, were also examined. Methods: This is a retrospective study of 426 patients with palpable neck masses from an outpatient department evaluated with computed tomography, magnetic resonance imaging, or US. US-guided FNABs were performed in 102 patients with suspicious malignant cervical lymph nodes at a single institution. Cytologically positive lymph nodes (n = 12) were further validated with excisional biopsy. Negative lymph nodes (n = 90) were either excised (n = 10) or followed up by imaging studies for at least one year (n = 80). The diagnostic accuracy of the FNABs along with the imaging findings of nodal sizes and presence of central necrosis, which were classified by a consensus of 2 radiologists, were assessed. Results: Twelve malignant nodes were detected with US-guided FANB with one false-positive and one false-negative result. The overall sensitivity, specificity, and accuracy for FNAB were 91.7%, 98.9%, and 98.0%, respectively. The sensitivity, specificity, and accuracy were 66.7%, 30.0%, and 34.3% for size criterion and 75.0%, 83.3%, and 82.3% for central necrosis criterion. Conclusions: The size of cervical lymph node does not appear to be an important imaging criterion for assessing suspicious malignant lymph nodes, compared with the criterion of central necrosis. US-guided FNAB is highly specific and sensitive in the diagnostic workup of suspicious malignant cervical lymph nodes in patients without known primary cancers.

Original languageEnglish
Pages (from-to)286-291
Number of pages6
JournalCanadian Association of Radiologists Journal
Volume58
Issue number5
Publication statusPublished - Dec 2007
Externally publishedYes

Fingerprint

Fine Needle Biopsy
Ultrasonography
Necrosis
Lymph Nodes
Neck
Sensitivity and Specificity
Diagnostic Imaging
Neoplasms
Outpatients
Retrospective Studies
Tomography
Magnetic Resonance Imaging
Biopsy

Keywords

  • Fine-needle aspiration
  • Lymph node
  • Malignancy
  • Neck
  • Ultrasound-guided biopsy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Detection of suspicious malignant cervical lymph nodes of unknown origin : Diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy with nodal size and central necrosis correlate. / Lo, Chung Ping; Chen, Cheng Yu; Chin, Shy Chyi; Lee, Kwo Whei; Hsueh, Chun Jen; Juan, Chun Jung; Kao, Hung Wen; Huang, Guo Shu.

In: Canadian Association of Radiologists Journal, Vol. 58, No. 5, 12.2007, p. 286-291.

Research output: Contribution to journalArticle

@article{398a0675dc7544418b21f8c67d180830,
title = "Detection of suspicious malignant cervical lymph nodes of unknown origin: Diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy with nodal size and central necrosis correlate",
abstract = "Objective: To assess the role of ultrasound-guided fine-needle aspiration biopsy (US-guided FNAB) in the diagnostic workup of suspicious malignant cervical lymph nodes in patients with palpable neck masses and without known primary cancer. The diagnostic accuracy of imaging morphologic criteria, including sizes and central necrosis for assessing suspicious malignant nodes, were also examined. Methods: This is a retrospective study of 426 patients with palpable neck masses from an outpatient department evaluated with computed tomography, magnetic resonance imaging, or US. US-guided FNABs were performed in 102 patients with suspicious malignant cervical lymph nodes at a single institution. Cytologically positive lymph nodes (n = 12) were further validated with excisional biopsy. Negative lymph nodes (n = 90) were either excised (n = 10) or followed up by imaging studies for at least one year (n = 80). The diagnostic accuracy of the FNABs along with the imaging findings of nodal sizes and presence of central necrosis, which were classified by a consensus of 2 radiologists, were assessed. Results: Twelve malignant nodes were detected with US-guided FANB with one false-positive and one false-negative result. The overall sensitivity, specificity, and accuracy for FNAB were 91.7{\%}, 98.9{\%}, and 98.0{\%}, respectively. The sensitivity, specificity, and accuracy were 66.7{\%}, 30.0{\%}, and 34.3{\%} for size criterion and 75.0{\%}, 83.3{\%}, and 82.3{\%} for central necrosis criterion. Conclusions: The size of cervical lymph node does not appear to be an important imaging criterion for assessing suspicious malignant lymph nodes, compared with the criterion of central necrosis. US-guided FNAB is highly specific and sensitive in the diagnostic workup of suspicious malignant cervical lymph nodes in patients without known primary cancers.",
keywords = "Fine-needle aspiration, Lymph node, Malignancy, Neck, Ultrasound-guided biopsy",
author = "Lo, {Chung Ping} and Chen, {Cheng Yu} and Chin, {Shy Chyi} and Lee, {Kwo Whei} and Hsueh, {Chun Jen} and Juan, {Chun Jung} and Kao, {Hung Wen} and Huang, {Guo Shu}",
year = "2007",
month = "12",
language = "English",
volume = "58",
pages = "286--291",
journal = "Canadian Association of Radiologists Journal",
issn = "0846-5371",
publisher = "Canadian Medical Association",
number = "5",

}

TY - JOUR

T1 - Detection of suspicious malignant cervical lymph nodes of unknown origin

T2 - Diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy with nodal size and central necrosis correlate

AU - Lo, Chung Ping

AU - Chen, Cheng Yu

AU - Chin, Shy Chyi

AU - Lee, Kwo Whei

AU - Hsueh, Chun Jen

AU - Juan, Chun Jung

AU - Kao, Hung Wen

AU - Huang, Guo Shu

PY - 2007/12

Y1 - 2007/12

N2 - Objective: To assess the role of ultrasound-guided fine-needle aspiration biopsy (US-guided FNAB) in the diagnostic workup of suspicious malignant cervical lymph nodes in patients with palpable neck masses and without known primary cancer. The diagnostic accuracy of imaging morphologic criteria, including sizes and central necrosis for assessing suspicious malignant nodes, were also examined. Methods: This is a retrospective study of 426 patients with palpable neck masses from an outpatient department evaluated with computed tomography, magnetic resonance imaging, or US. US-guided FNABs were performed in 102 patients with suspicious malignant cervical lymph nodes at a single institution. Cytologically positive lymph nodes (n = 12) were further validated with excisional biopsy. Negative lymph nodes (n = 90) were either excised (n = 10) or followed up by imaging studies for at least one year (n = 80). The diagnostic accuracy of the FNABs along with the imaging findings of nodal sizes and presence of central necrosis, which were classified by a consensus of 2 radiologists, were assessed. Results: Twelve malignant nodes were detected with US-guided FANB with one false-positive and one false-negative result. The overall sensitivity, specificity, and accuracy for FNAB were 91.7%, 98.9%, and 98.0%, respectively. The sensitivity, specificity, and accuracy were 66.7%, 30.0%, and 34.3% for size criterion and 75.0%, 83.3%, and 82.3% for central necrosis criterion. Conclusions: The size of cervical lymph node does not appear to be an important imaging criterion for assessing suspicious malignant lymph nodes, compared with the criterion of central necrosis. US-guided FNAB is highly specific and sensitive in the diagnostic workup of suspicious malignant cervical lymph nodes in patients without known primary cancers.

AB - Objective: To assess the role of ultrasound-guided fine-needle aspiration biopsy (US-guided FNAB) in the diagnostic workup of suspicious malignant cervical lymph nodes in patients with palpable neck masses and without known primary cancer. The diagnostic accuracy of imaging morphologic criteria, including sizes and central necrosis for assessing suspicious malignant nodes, were also examined. Methods: This is a retrospective study of 426 patients with palpable neck masses from an outpatient department evaluated with computed tomography, magnetic resonance imaging, or US. US-guided FNABs were performed in 102 patients with suspicious malignant cervical lymph nodes at a single institution. Cytologically positive lymph nodes (n = 12) were further validated with excisional biopsy. Negative lymph nodes (n = 90) were either excised (n = 10) or followed up by imaging studies for at least one year (n = 80). The diagnostic accuracy of the FNABs along with the imaging findings of nodal sizes and presence of central necrosis, which were classified by a consensus of 2 radiologists, were assessed. Results: Twelve malignant nodes were detected with US-guided FANB with one false-positive and one false-negative result. The overall sensitivity, specificity, and accuracy for FNAB were 91.7%, 98.9%, and 98.0%, respectively. The sensitivity, specificity, and accuracy were 66.7%, 30.0%, and 34.3% for size criterion and 75.0%, 83.3%, and 82.3% for central necrosis criterion. Conclusions: The size of cervical lymph node does not appear to be an important imaging criterion for assessing suspicious malignant lymph nodes, compared with the criterion of central necrosis. US-guided FNAB is highly specific and sensitive in the diagnostic workup of suspicious malignant cervical lymph nodes in patients without known primary cancers.

KW - Fine-needle aspiration

KW - Lymph node

KW - Malignancy

KW - Neck

KW - Ultrasound-guided biopsy

UR - http://www.scopus.com/inward/record.url?scp=38149063479&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38149063479&partnerID=8YFLogxK

M3 - Article

VL - 58

SP - 286

EP - 291

JO - Canadian Association of Radiologists Journal

JF - Canadian Association of Radiologists Journal

SN - 0846-5371

IS - 5

ER -