Turbo short tau inversion recovery imaging for metastatic node screening in patients with head and neck cancer

A rapid and sensitive MR imaging technique would be beneficial for screening of metastatic nodes in the neck. We preliminarily evaluated the coronal MR imaging with a turbo short tau inversion recovery (STIR) sequence for that purpose.

The coronal turbo STIR imaging (repetition time [TR]/echo time [TE]/inversion time [TI] = 3850 ms/20 or 80 ms/180 ms) and axial fat-suppressed spectral presaturation with inversion recovery (SPIR) T2-weighted imaging (fsT2WI) (TR/TE = 3500 ms/80 ms) were performed on 29 patients with head and neck cancer. We obtained coronal turbo STIR images and axial fsT2WI of the necks. The section thickness, intersection gap, matrix size, and field of view were the same in both techniques. The diagnostic ability for metastatic nodes was assessed at each neck level by using various cutoff size criteria. The nodal involvement was confirmed by histologic examination.

The image acquisition time for the whole neck by coronal turbo STIR and axial fsT2WI techniques was approximately 2 minutes and 4 minutes, respectively. When the size criteria (cutoff sizes of short axis diameter were 8 mm at level I and 5 mm at levels II and III) were used, the STIR imaging yielded compromised diagnostic ability having 100% sensitivity and 100% negative predictive value (NPV). fsT2WI technique yielded 100 sensitivity and 100% NPV by using cutoff sizes of 6 mm at levels I and II and 5 mm at level III.

Coronal STIR imaging provided a rapid screening technique for cervical metastatic nodes and could be a diagnostic tool before detailed MR studies of the neck.