Article
The value of ultrasound in head and neck cancer follow-up
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Authors
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Maximilian Traxdorf
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Erlangen, Germany
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Johannes Zenk
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Erlangen, Germany
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Michael Koch
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Erlangen, Germany
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Heinrich Iro
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Erlangen, Germany
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Alessandro Bozzato
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Erlangen, Germany
| Published: | July 23, 2012 |
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Outline
Text
Introduction: Various imaging procedures such as computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET) are used for staging oncological patients. Following the introduction of ultrasound into diagnostic procedures in the head and neck region, modern ultrasound procedures have undoubtedly gained in importance. Looking back on 5.000 ultrasound examinations per year in the ENT Department of the University of Erlangen we perform approximately 3.000 high resolution ultrasonographies in the context of primary staging and tumor follow-up care. Background of this study was to determine the value of ultrasound in comparison to competing imaging techniques in head and neck cancer patients.
Methods: Literature research and comparison of own results with various imaging concepts and current studies performing ultrasound in head and neck oncology.
Results: Widely varying studies have reported sensitivity rates for ultrasound detection of cervical lymph-node metastases in the range of 78–98%, with specificities of 61–97% . [1], [2], [3], [4]. High resolution ultrasonography provides the highest sensitivity for detecting pathological conditions in the area of the salivary glands or cervical lymph-node metastases, while PET/CT appears to offer the highest specificity [5]. Ultrasound-guided needle biopsies can be regarded as the imaging procedure of choice for detecting lymph-node metastases, in comparison with CT and MRI [6]. Contrast enhanced imaging techniques like CT and MRI are superior to ultrasound diagnosis for assessing the extent of the tumor in the area of the mandible, nasopharynx, and retropharynx, as well as in the oral cavity and trachea.
Conclusion: The few studies that compared ultrasound, CT, and MRI clearly refute the impression that CT and MRI are superior. In conclusion, therefore, it may be emphasized that the use of ultrasound to detect and follow up tumors has now become an indispensable component of the treatment protocol of head and neck cancer patients.
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