A Proposed Method for Cervical Lymph Node Evaluation in Head and Neck Cancer Patients: A Radiological Study

Objectives To present a new method to assess the cervical lymph nodes status in head and neck cancer patients. Methods Twenty-five oral and maxillofacial cancer patients underwent preoperative CT imaging. The cervical lymph node features on CT scan were examined. Each parameter was given a score, and the total scores in each case was calculated and referred to as metastatic score (MS). Then, patients underwent neck dissection, and all dissected lymph nodes were sent for histopathology. Results All cases with MS >= 6 were histopathologically positive, and all cases with MS <= 3 were histopathologically negative. All cases of nodal sizes > 3 cm were histopathologically positive, 82% of cases of nodal sizes between 2.1 and 3 cm were histopathologically positive, 40% of cases of nodal sizes between 1 and 2 cm were histopathologically positive, and all cases of lymph nodes sizes < 1 cm were histopathologically negative. Seventy-seven percent of cases which had a group of lymph nodes >= 3 nodes/region were histopathologically positive, while 79% of cases with rounded nodes were histopathologically positive, and all cases with necrotic lymph nodes were positive for malignancy. Conclusion The proposed formula is a good assessment tool for cervical lymph nodes evaluation using helical CT scan in head and neck cancer patients.