Assessment of cervical metastatic disease

Ultrasound of the neck is, when combined with ultrasound-guided fine-needle aspiration biopsy (UGFNAB), an accurate test for nodal disease in patients with head and neck squamous cell cancer (HNSCC). The combined procedure is characterized by high sensitivity and specificity. Therefore, the technique is suited for demonstrating, detecting and excluding cervical metastatic disease. This paper will discuss how to interpret the diagnostic information supplied by US-UGFNAB. It is concluded that US-UGFNAB is a promising concept of methodic use of both an imaging technique and cytopathologic examination in the evaluation of patients with HNSCC. Application of the combined procedure may produce a more accurate classification of these patients and may change indications for therapeutic and elective neck treatment. In addition, US-UGFNAB may prove to be valuable during follow-up of patients with HNSCC, in the accurate preoperative assessment of the carotid artery in patients with metastatic neck disease, and the detection of lymph nodes in patients with malignancies other than HNSCC.