Sonography for the detection of cervical lymph node metastases among patients with tongue cancer: Criteria for early detection and assessment of follow-up examination intervals

Kenji Yuasa, Toshiyuki Kawazu, Naonobu Kunitake, Satoru Uehara, Junichi Omagari, Kazunori Yoshiura, Eiji Nakayama, Shigenobu Kanda

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: Because the presence of cervical metastasis is one of the factors influencing the outcome of patients with carcinoma of the head and neck, its early detection is potentially very important. The purpose of this study was to evaluate the characteristic changes of cervical metastasis revealed by sonography during follow-up and to assess an adequate interval for follow-up sonography of the neck among patients with tongue cancer. METHODS: Forty-three of 44 consecutive patients with squamous cell carcinoma of the tongue, who had undergone interstitial brachytherapy, were examined with sonography of the neck during the posttherapeutic follow-up period. RESULTS: Seventeen cervical lymph node metastases were found in 12 of 43 patients during follow-up. Of these 17 cervical metastases, 16 (94.1%) were accurately diagnosed and one (5.9%) was misdiagnosed as nonmetastatic based on sonographic findings. Sonography of the neck performed in seven patients at an interval of less than 1 month since the last follow-up imaging showed 9 (90.0%) of 10 metastases increased by up to 2 mm in short-axis diameter. Five patients who were followed up at an interval of more than 1 month since the last follow-up imaging had seven metastases increase by 3 to 8 mm in short-axis diameter or a change of echogenicity in the internal structure of lymph nodes or both. Pathologic examinations showed extranodal spread in 3 (4.2.9%) of these 7 metastases. CONCLUSION: Changes both in size and internal echogenicity can occur as quickly as 2 to 4 weeks between sonographic examinations. Therefore, in high-risk patients, or in those with suspicious sonographic findings, short-interval follow-up sonographic examinations are recommended at least during the first posttherapeutic year. Our findings suggest that follow-up sonography of the neck should be performed monthly, at least during the first posttherapeutic year.

Original languageEnglish
Pages (from-to)1127-1132
Number of pages6
JournalAmerican Journal of Neuroradiology
Volume21
Issue number6
Publication statusPublished - Jun 30 2000
Externally publishedYes

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Tongue Neoplasms
Ultrasonography
Lymph Nodes
Neoplasm Metastasis
Neck
Brachytherapy
Diagnostic Errors
Tongue
Squamous Cell Carcinoma
Head
Carcinoma

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Sonography for the detection of cervical lymph node metastases among patients with tongue cancer : Criteria for early detection and assessment of follow-up examination intervals. / Yuasa, Kenji; Kawazu, Toshiyuki; Kunitake, Naonobu; Uehara, Satoru; Omagari, Junichi; Yoshiura, Kazunori; Nakayama, Eiji; Kanda, Shigenobu.

In: American Journal of Neuroradiology, Vol. 21, No. 6, 30.06.2000, p. 1127-1132.

Research output: Contribution to journalArticle

Yuasa, Kenji ; Kawazu, Toshiyuki ; Kunitake, Naonobu ; Uehara, Satoru ; Omagari, Junichi ; Yoshiura, Kazunori ; Nakayama, Eiji ; Kanda, Shigenobu. / Sonography for the detection of cervical lymph node metastases among patients with tongue cancer : Criteria for early detection and assessment of follow-up examination intervals. In: American Journal of Neuroradiology. 2000 ; Vol. 21, No. 6. pp. 1127-1132.
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abstract = "BACKGROUND AND PURPOSE: Because the presence of cervical metastasis is one of the factors influencing the outcome of patients with carcinoma of the head and neck, its early detection is potentially very important. The purpose of this study was to evaluate the characteristic changes of cervical metastasis revealed by sonography during follow-up and to assess an adequate interval for follow-up sonography of the neck among patients with tongue cancer. METHODS: Forty-three of 44 consecutive patients with squamous cell carcinoma of the tongue, who had undergone interstitial brachytherapy, were examined with sonography of the neck during the posttherapeutic follow-up period. RESULTS: Seventeen cervical lymph node metastases were found in 12 of 43 patients during follow-up. Of these 17 cervical metastases, 16 (94.1{\%}) were accurately diagnosed and one (5.9{\%}) was misdiagnosed as nonmetastatic based on sonographic findings. Sonography of the neck performed in seven patients at an interval of less than 1 month since the last follow-up imaging showed 9 (90.0{\%}) of 10 metastases increased by up to 2 mm in short-axis diameter. Five patients who were followed up at an interval of more than 1 month since the last follow-up imaging had seven metastases increase by 3 to 8 mm in short-axis diameter or a change of echogenicity in the internal structure of lymph nodes or both. Pathologic examinations showed extranodal spread in 3 (4.2.9{\%}) of these 7 metastases. CONCLUSION: Changes both in size and internal echogenicity can occur as quickly as 2 to 4 weeks between sonographic examinations. Therefore, in high-risk patients, or in those with suspicious sonographic findings, short-interval follow-up sonographic examinations are recommended at least during the first posttherapeutic year. Our findings suggest that follow-up sonography of the neck should be performed monthly, at least during the first posttherapeutic year.",
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T1 - Sonography for the detection of cervical lymph node metastases among patients with tongue cancer

T2 - Criteria for early detection and assessment of follow-up examination intervals

AU - Yuasa, Kenji

AU - Kawazu, Toshiyuki

AU - Kunitake, Naonobu

AU - Uehara, Satoru

AU - Omagari, Junichi

AU - Yoshiura, Kazunori

AU - Nakayama, Eiji

AU - Kanda, Shigenobu

PY - 2000/6/30

Y1 - 2000/6/30

N2 - BACKGROUND AND PURPOSE: Because the presence of cervical metastasis is one of the factors influencing the outcome of patients with carcinoma of the head and neck, its early detection is potentially very important. The purpose of this study was to evaluate the characteristic changes of cervical metastasis revealed by sonography during follow-up and to assess an adequate interval for follow-up sonography of the neck among patients with tongue cancer. METHODS: Forty-three of 44 consecutive patients with squamous cell carcinoma of the tongue, who had undergone interstitial brachytherapy, were examined with sonography of the neck during the posttherapeutic follow-up period. RESULTS: Seventeen cervical lymph node metastases were found in 12 of 43 patients during follow-up. Of these 17 cervical metastases, 16 (94.1%) were accurately diagnosed and one (5.9%) was misdiagnosed as nonmetastatic based on sonographic findings. Sonography of the neck performed in seven patients at an interval of less than 1 month since the last follow-up imaging showed 9 (90.0%) of 10 metastases increased by up to 2 mm in short-axis diameter. Five patients who were followed up at an interval of more than 1 month since the last follow-up imaging had seven metastases increase by 3 to 8 mm in short-axis diameter or a change of echogenicity in the internal structure of lymph nodes or both. Pathologic examinations showed extranodal spread in 3 (4.2.9%) of these 7 metastases. CONCLUSION: Changes both in size and internal echogenicity can occur as quickly as 2 to 4 weeks between sonographic examinations. Therefore, in high-risk patients, or in those with suspicious sonographic findings, short-interval follow-up sonographic examinations are recommended at least during the first posttherapeutic year. Our findings suggest that follow-up sonography of the neck should be performed monthly, at least during the first posttherapeutic year.

AB - BACKGROUND AND PURPOSE: Because the presence of cervical metastasis is one of the factors influencing the outcome of patients with carcinoma of the head and neck, its early detection is potentially very important. The purpose of this study was to evaluate the characteristic changes of cervical metastasis revealed by sonography during follow-up and to assess an adequate interval for follow-up sonography of the neck among patients with tongue cancer. METHODS: Forty-three of 44 consecutive patients with squamous cell carcinoma of the tongue, who had undergone interstitial brachytherapy, were examined with sonography of the neck during the posttherapeutic follow-up period. RESULTS: Seventeen cervical lymph node metastases were found in 12 of 43 patients during follow-up. Of these 17 cervical metastases, 16 (94.1%) were accurately diagnosed and one (5.9%) was misdiagnosed as nonmetastatic based on sonographic findings. Sonography of the neck performed in seven patients at an interval of less than 1 month since the last follow-up imaging showed 9 (90.0%) of 10 metastases increased by up to 2 mm in short-axis diameter. Five patients who were followed up at an interval of more than 1 month since the last follow-up imaging had seven metastases increase by 3 to 8 mm in short-axis diameter or a change of echogenicity in the internal structure of lymph nodes or both. Pathologic examinations showed extranodal spread in 3 (4.2.9%) of these 7 metastases. CONCLUSION: Changes both in size and internal echogenicity can occur as quickly as 2 to 4 weeks between sonographic examinations. Therefore, in high-risk patients, or in those with suspicious sonographic findings, short-interval follow-up sonographic examinations are recommended at least during the first posttherapeutic year. Our findings suggest that follow-up sonography of the neck should be performed monthly, at least during the first posttherapeutic year.

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