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Congress: ECR24
Poster Number: C-11913
Type: EPOS Radiologist (scientific)
Authorblock: E. Cho, H. J. Baek, Y. Jeong; Changwon/KR
Disclosures:
Eun Cho: Nothing to disclose
Hye Jin Baek: Nothing to disclose
Yujin Jeong: Nothing to disclose
Keywords: Head and neck, CT, Ultrasound, Biopsy, Cancer, Metastases
Purpose The supraclavicular lymph nodes (ScLNs) comprise a final common pathway of metastatic nodal involvement from various malignancies. Thus, ScLN metastases are important in oncology patients for staging.Noninvasive techniques such as CT and US can be used to detection of ScLN metastasis. However, evaluation using chest CT has a limitation related to its sensitivity and specificity and performing US-guided tissue sampling of all LNs detected on CT is invasive for patients and no cost-effective.Therefore, the purpose of this study was to...
Read more Methods and materials <Patients> [fig 1] Study patients (87 oncology patients)  M : F = 59 (67.8%) : 28 (32.2%) Age: 64.7 ± 11.6 years (range, 30-88 years) Primary site of malignancies: lung cancer (n = 51), esophageal cancer (n = 9), breast cancer (n = 8), pancreas cancer (n = 7), gastric cancer (n = 6), prostate cancer (n = 5), hypopharyngeal cancer (n = 1) <Clinical and Radiological factors>Clinical factors Sex, age, lung disease (i.e., anthracofibrosis, pneumonia, interstitial lung disease), malignancy type (lung cancer vs. non-lung cancer) US evaluation by...
Read more Results [fig 2] 87 patients with suspicious ScLNs on chest CT  49 patients (56.3%) : metastatic LN 26 patients (29.9%) : negative for malignancy 12 patients (13.8%) : pseudo-lesion partial volume artifact of the anterior scalene muscles   [fig 3] The diagnostic indices of subsequent neck US for the 87 patients with true LNs detected on chest CT  Sensitivity: 91.8% Specificity: 92.3% PPV: 95.7% NPV: 85.7% Accuracy: 92.0% [fig 1] [fig 2] [fig 4] [fig 5] [fig 6] [fig 7]
Read more Conclusion The false-positive group had a significantly higher mean age than the true-positive group.The presence of benign lung conditions showed a high tendency of false-positive rate, but there was no statistically significant.Subsequent US can be helpful for evaluating suspicious ScLN detected on chest CT to avoid unnecessary tissue sampling.Also, clinical awareness of accurate lower neck anatomy and patients’ medical history, and meticulous image inspection are necessary to establish the appropriate diagnostic workflow using rational and cost-effective strategies for the management in...
Read more References [1] Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, Sullivan DC, et al. AJCC Cancer Staging Manual; Springer: New York, NY, USA, 2017. [2] Fultz PJ, Harrow AR, Elvey SP, Feins RH, Strang JG, Wandtke JC, et al. Sonographically guided biopsy of supraclavicular lymph nodes: a simple alternative to lung biopsy and other more invasive procedures. AJR Am J Roentgenol 2003;180:1403-1409. [3] van Overhagen H, Laméris JS, Berger MY, van der Voorde...
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