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Evaluation of Contrast-Enhanced Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in the Detection of Retropharyngeal Lymph Node Metastases in Nasopharyngeal Carcinoma Patients

Authors Chen J, Luo J, He X, Zhu C

Received 29 December 2019

Accepted for publication 21 February 2020

Published 9 March 2020 Volume 2020:12 Pages 1733—1739

DOI https://doi.org/10.2147/CMAR.S244034

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Chien-Feng Li


Jie Chen,1 Jingwen Luo,2 Xia He,3 Chenjing Zhu3

1Department of Oncology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Department of Oncology, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 3Department of Radiation Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China

Correspondence: Xia He; Chenjing Zhu
Department of Radiation Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Tel/Fax +86-28-85475576
Email hexiabm@163.com; drchenjingzhu@gmail.com

Introduction: We performed this study to explore the diagnostic accuracies and cutoff values of contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) for the detection and diagnosis of metastatic retropharyngeal lymph nodes (RLNs) in patients with nasopharyngeal carcinoma (NPC).
Methods: One hundred and twenty-eight patients with a total of 159 RLNs were included in the study. The sizes of maximal and minimal axial diameters of each node on both contrast-enhanced CT and MRI images were measured. The characteristics of the RLNs (malignant or benign), as well as the survival of patients, were classified based on the results of follow-up MRI.
Results: RLN size cutoffs of 4– 11 mm for minimal axial diameter were used. We found that MRI showed higher sensitivity while CT demonstrated higher specificity. The reasonable criterion for the diagnosis of metastatic RLNs in MRI was a minimal axial diameter of ≥ 6 mm, which yielded a sensitivity, specificity and diagnostic odds ratio (DOR) of 0.71, 0.82 and 10.88.
Conclusion: The radiologic criteria that should be used for the assessment of RLN metastases in NPC patients are nodes with a minimal axial diameter of ≥ 6 mm on MR images.

Keywords: retropharyngeal lymph node, metastasis, nasopharyngeal carcinoma, cutoff, MRI

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