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Updated: May 13, 2026
A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
Can extranodal spread in head and neck cancer be detected on MR imaging
Wouter L Lodder1, Charlotte A H Lange, Marie-Louise F van Velthuysen
1Department of Head & Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. w.l.lodder@gmail.com
Objectives:
The aim of this study is to determine a set of MRI lymph node characteristics predictive for extranodal tumor spread (ENS) in head and neck cancer patients.
Methods:
In 39 patients, 60 lymph nodes with on MRI a minimal axial diameter of more than 1cm or an inhomogeneous enhancement were studied. Two radiologists evaluated all MR-images for findings potentially indicative of the presence of ENS. Sensitivity, specificity and odds ratios based on logistic regression were calculated.
Results:
On MR-imaging, 20 lymph nodes were staged positive for ENS. On histopathology, 30 nodes were positive for ENS. In total, 14 nodes (23%) were scored differently on MR-imaging and histopathology. The MR-finding "infiltration of adjacent planes" established a specificity of 100% (lower 90% confidence bound: 91%) and sensitivity of 50% (95% confidence interval [CI]: 28-72%).
Conclusion:
The MRI finding "infiltration of adjacent planes" may be high enough (100% in our study) to be used for treatment planning.
