AbstractPurpose: Comparing and evaluating cervical lymph nodes by USG and CT with Histopathological correlation in patients with head and neck malignancy. To assess the diagnostic accuracy of both Ultrasonography [USG] and Computed Tomography [CT] in preoperative evaluation of the cervical nodal status in patients with head and neck malignancy.
Materials and Methods: A prospective study was done from October 2017 to march 2019 on all patients with suspected primary or recurrent head and neck malignancy who are referred to Department of Radio-Diagnosis, Siddhartha Medical College Hospital and Research centre, Tumkur. After obtaining the consent, we analyze cervical lymph nodes (metastatic and nonmetastatic) from patients with head and neck malignancy. All these nodes will be examined on gray-scale and power Doppler sonography and also on CT. Topographic correlations, between dissected nodes and sonograms and between dissected nodes and CT images, will be performed for each node.
Results: Our study out of 36 subjects evaluated for head and neck malignancy USG had a high sensitivity of 96%, Specificity of 49%, positive predictive value of 87% and also a negative predictive value of 66% with accuracy of 86%, CT had a high sensitivity of 96%, Specificity of 56%, positive predictive value of 90% and also a negative predictive value of 75% with accuracy of 88%. The above table has a p value of 0.001 which is considered as very highly significant. Kappa Statistics was calculated and it was found to be 0.712, which is considered as good agreement.
Conclusion: Ultrasonographic examination is very sensitive in differentiating between cystic/necrotic foci and solid swellings. Colour Doppler Sonography provides additional information on vasculature of the lymph nodes and plays an important role in differentiating between the benign, reactive and malignant cervical lymphadenopathy. Multidetector CT provides improved localisation and characterization of cervical lymph nodes.
