Diagnostic accuracy of multislice CT scan in the detection of occult cervical lymph node metastasis in head and neck cancers

Objective: To determine the diagnostic accuracy of CECT in detecting occult cervical lymph node metastasis in primary head and neck squamous cell carcinoma (SCC) patients with clinically negative cervical nodes, keeping histopathology as gold standard. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Radiology, Dow International Medical College, DUHS, Karachi from October 2015 till April 2016. Methodology: Two hundred patients of head and neck squamous cell carcinoma patients with clinically negative cervical nodes were enrolled at Department of Radiology, Dow International Medical College, DUHS, Karachi from October 2015 till April 2016. Multidetector computed tomography (MDCT) was done and lesions were assessed for presence or absence of tumor to metastasis into cervical lymph nodes. Histopathology was used as gold standard. Results: The mean age was 44.89 +-9.82 years as majority of the patents were males (58.0%). CECT findings showed 48.5% positive cases, while histopathology findings showed that there were 48.39% positive cases with sensitivity, specificity, NPV, PPV and overall diagnostic accuracy of 100%, 93%, 93%, 100% and 96.21%. Conclusion: MDCT is a very effective modality in early diagnosis of cancerous involvement of SCC and its invasion into cervical lymph node metastasis promising early detection and treatment. (author)