Regional metastasis in head and neck squamous cell carcinoma: revised value of US with US-guided FNAB

Radiology. 1996 Mar;198(3):819-23. doi: 10.1148/radiology.198.3.8628877.


Purpose: To verify the acclaimed accuracy of ultrasound (US) combined with US-guided fine-needle aspiration biopsy (FNAB) in the detection of lymph node metastasis in the neck and to evaluate the interobserver variability.

Materials and methods: In a prospective, multicenter study of 185 patients with head and neck squamous cell carcinoma, US (n=238 neck sides) with US-guided FNAB (n=178 neck sides) was used for evaluation of the lymph node status of the neck. Findings were correlated with those of histopathologic examination in 238 neck sides.

Results: US with US-guided FNAB had a sensitivity of 77% and a specificity of 100%. Nineteen of 178 aspirations were nondiagnostic. There were no significant differences between the four participating hospitals or the individual sonologists (P>.05).

Conclusion: Sensitivity of US with US-guided FNAB was slightly lower compared with previous reports. Specificity was similar to previous reports. Interobserver variability appeared to be low. The validity of US with US-guided FNAB is high and warrants widespread use of the procedure for evaluation of the neck.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle*
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / secondary*
  • Female
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Lymphatic Metastasis / diagnosis
  • Lymphatic Metastasis / diagnostic imaging
  • Male
  • Middle Aged
  • Neck
  • Observer Variation
  • Palpation
  • Prospective Studies
  • Sensitivity and Specificity
  • Ultrasonography