CT for estimating adequacy of lymph node dissection in patients with squamous cell carcinoma of the head and neck

Cancer Imaging

Joshua H. Litchman¹  Mariah M. Servos²  Christiaan A. Rees²  Darcy A. Kerr³  David A. Pastel⁴  Joseph A. Paydarfar⁵  Ryan J. Halter⁶  Xiaotian Wu⁷ 

[1] Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA;Geisel School of Medicine at Dartmouth, Hanover, NH, USA;Geisel School of Medicine at Dartmouth, Hanover, NH, USA;Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA;Geisel School of Medicine at Dartmouth, Hanover, NH, USA;Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA;Geisel School of Medicine at Dartmouth, Hanover, NH, USA;Section of Otolaryngology, Dartmouth-Hitchcock Medical Center, 03756, Lebanon, NH, USA;Geisel School of Medicine at Dartmouth, Hanover, NH, USA;Thayer School of Engineering, Dartmouth College, Hanover, NH, USA;Thayer School of Engineering, Dartmouth College, Hanover, NH, USA;

关键词: 3D reconstruction;    Computational modeling;    Head and neck;    Lymph node ratio;    Lymph node yield;    Neck dissection;   

DOI  :  10.1186/s40644-021-00430-6

来源: Springer

【 摘 要 】

BackgroundIndices obtained from lymph node dissection specimens, specifically lymph node yield (LNY) and lymph node ratio (LNR), have prognostic significance in the setting of head and neck squamous cell carcinoma (HNSCCa). However, there are currently no validated tools to estimate adequacy of planned lymph node dissection using preoperative data. The present study sought to evaluate CT-derived estimates of lymphatic tissue volumes as a preoperative tool to guide cervical node dissection.MethodsFifteen cervical lymph node dissections were performed in 14 subjects with HNSCCa. Preoperative CT-derived estimates of lymphatic tissue volumes were compared with gross pathology tissue volume estimates and pathologically-determined LNY.ResultsResected tissue volume (calculated using the triaxial ellipsoid method) correlates with CT-derived preoperative lymphatic volume estimates (r = 0.74, p = 0.003) while LNY does not(r = − 0.12, p = 0.67). When excluding pathologically enlarged lymph nodes (“refined” data), a negative correlation was observed between refined CT-derived volume estimates and refined LNY (r = − 0.65, p = 0.009).ConclusionIn the setting of cervical lymph node dissection, CT-derived lymphatic volume estimates correlate with resected tissue volume, but refined CT-derived volume estimates correlate negatively with refined LNY.Trial registrationRetrospectively registered.Level of evidence4

【 授权许可】

CC BY