DIAGNOSTIC ACCURACY OF CT SCAN FOR DETECTION OF METASTATIC CERVICAL LYMPH NODES

Abstract

Objective: To determine diagnostic accuracy of computed tomography (CT) scan in detecting metastatic cervical lymph nodes in cases of clinically N0 stage head and neck carcinomas using histopathology as gold standard.

Study Design: Validation study.

Place and Duration of Study: Department of radiology, Military Hospital Rawalpindi - a tertiary care hospital in collaboration with AFIP from 1st Jun 2012 to 31st Jun 2013.

Material and Methods: Two hundred and seventy known cases of head and neck carcinoma with clinically N0 stage were subjected to pre-operative CT scan with contrast. Patients with CT scan positive for cervical metastasis underwent fine needle aspiration cytology (FNAC) / neck dissection (ND) while elective neck dissection (END) was performed in patients having CT scan negative for cervical lymphadenopathy. CT findings were compared with histopathology and analyzed to determine sensitivity, specificity and diagnostic accuracy of CT scan in diagnosing cervical metastasis.

Results: The mean age of patients was 56.73 ± 8.81 years out of these 210 (78%) were male while 60 (22%) were female making male-to-female ratio 3.5:1. Sensitivity, specificity, positive and negative predictive value of CT scan were 89.7%, 90.0%, 88.1% and 92.1% respectively in prediction of cervical metastatic lymphadenopathy while overall diagnostic accuracy of CT scan was 90.4%.

Conclusion: CT scan is a reliable diagnostic tool for diagnosis of metastatic cervical lymph nodes in cases of N0 head and neck carcinomas.