Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries

Rikke Norling, Cai Grau, Michael B. Nielsen, Preben Homøe, Jens A. Sørensen, Karin Lambertsen, Troels Bundgaard, Antti Mäkitie, Reidar Grénman, Jussi Larenne, Petri Koivunen, Jukka Virtaniemi, Arnar Gudjonsson, Olav Jetlund, Helmut Abendstein, Oddveig Rikardsen, Stein Lybak, Johan Wennerberg, Anders Högmo, Göran LaurellAnders Westerborn, Eva Hammerlid, Wieslaw Tytor, Lena Cederblad, Christian Von Buchwald

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Abstrakt

Background. Fast and accurate work-up is crucial to ensure the best possible treatment and prognosis for patients with head and neck cancer. The presence or absence of neck lymph node metastases is important for the prognosis and the choice of treatment. Clinical lymph node (N)-staging is done by palpation and diagnostic imaging of the neck. We investigated the current practice of the initial radiological work-up of patients with oral squamous cell carcinomas (OSCC) in the Nordic countries. Methods. A questionnaire regarding the availability and use of guidelines and imaging modalities for radiological N-staging in OSCC was distributed to 21 Head and Neck centres in Denmark (n = 4), Finland (n = 5), Iceland (n = 1), Norway (n = 4) and Sweden (n = 7). We also asked for a description of the radiological criteria for determining the lymph nodes as clinical positive (cN+) or negative (cN0). Results. All 21 Head and Neck centres responded to the questionnaire. Denmark and Finland have national guidelines, while Norway and Sweden have local or regional guidelines. Seventeen of the 19 centres with available guidelines recommended computed tomography (CT) of the cN0 neck. The waiting time may influence the imaging modalities used. Lymph node size was the most commonly used criteria for radiological cN+, but the cut-off measures vary from 0.8 to 2.0 cm. Conclusion. Overall, CT is the most commonly recommended and used imaging modality for OSCC. Despite availability of national guidelines the type and number of radiological examinations vary between centres within a country, but the implementation of a fast-track programme may facilitate fast access to imaging. The absence of uniform criteria for determining the lymph nodes of the neck as cN+ complicates the comparison of the accuracy of the imaging modalities. Well-defined radiological strategies and criteria are needed to optimise the radiological work-up in OSCC.

OriginalsprogEngelsk
Sider (fra-til)355-361
Antal sider7
TidsskriftActa Oncologica
Vol/bind51
Udgave nummer3
DOI
StatusUdgivet - 1 mar. 2012

Fingeraftryk Udforsk hvilke forskningsemner 'Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries' indeholder.

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