Diagnostic efficacy of computed tomography in detecting cervical metastases in clinically N0 head and neck squamous cell carcinoma

Abstract

The search for a single non-invasive highly accurate diagnostic modality for identification of cervical metastasis in head and neck squamous cell carcinoma (HNSCC) is yet to bear fruit. Thirty proven cases of HNSCC with no palpable neck nodes were selected, requiring surgery for the primary tumour. Detailed clinical evaluation and contrast enhanced computed tomography (CECT) scans were done. Patients underwent elective neck dissection along with surgery for the primary tumour. Specimens were sent for histopathological examination (HPE), considered gold standard. Results of CECT were compared with HPE. Clinical examination had a NPV of 80 % and CECT had a sensitivity, specificity, PPV, NPV, and accuracy of 83, 75, 45.5, 94.7, and 76.7 % respectively. A CECT may be added to the initial assessment of a patient of HNSCC, allowing for earlier diagnosis of nodal metastasis that may allow for a better chance at survival.