Ultrasound Is Beneficial to Determine Lymphadenopathy in Oral Cancer Patients after Radiotherapy
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameters | n (%) or Mean ± SD |
---|---|
Age (years) | 55 ± 11 |
Sex (Female/Male) | 10 (10%)/94 (90%) |
Duration between RT/CRT and imaging examination (days) | 504 ± 704 |
Examinations that patients received | |
MRI/CT | 4 (4%)/100 (96%) |
US | 104 (100%) |
FNA | 93 (89%) |
Primary cancer subsite | |
Tongue/Buccal area/Gingiva/ Palate/Mouth floor/Retromolar trigone | 51 (49%)/28 (27%)/13 (12%)/5 (5%)/1 (1%)/4 (4%) |
Level of lymphadenopathy | |
I/II/III | 43 (41%)/26 (25%)/14 (13%) |
IV/V/VI | 6 (6%)/8 (8%)/7 (7%) |
Sonographic feature of lymphadenopathy | |
Short axis (cm) | 1.07 ± 0.57 |
Long axis (cm) | 1.66 ± 0.89 |
S/L | 0.66 ± 0.16 |
Margin (Clear/Vague) | 58 (56%)/46 (44%) |
Internal echogenicity (Homo-/Hetero-geneous) | 47 (45%)/57 (55%) |
Echogenicity (Hyper- or Iso-/Hypo-echogenicity) | 5 (5%)/99 (95%) |
Calcification (Absent/Present) | 95 (91%)/9 (9%) |
Architecture (Cystic/Solid) | 20 (19%)/84 (81%) |
Echogenic hilum (Absent/Present) | 85 (82%)/19 (18%) |
Vascular pattern (Hilar or Avascular/Others) | 88 (85%)/15 (15%) |
Parameters, n (%) or Mean ± SD | Recurrent Patients (n = 68) | Non-Recurrent Patients (n = 36) | p-Value |
---|---|---|---|
Age (years) | 57 ± 12 | 53 ± 9 | 0.084 |
Sex | 0.398 | ||
Female | 8 (12%) | 2 (6%) | |
Male | 60 (88%) | 34 (94%) | |
Duration between RT/CRT and imaging examination (days) | 344 ± 486 | 806 ± 929 | 0.001 * |
Examination that patients received | 0.680 | ||
MRI | 65 (96%) | 35 (97%) | |
CT | 3 (4%) | 1 (3%) | |
Primary cancer subsite | 0.393 | ||
Tongue | 33 (49%) | 18 (50%) | |
Buccal area | 15 (22%) | 13 (36%) | |
Gingiva | 10 (15%) | 3 (8%) | |
Palate | 3 (4%) | 2 (6%) | |
Lip | 1 (1%) | 0 (0%) | |
Mouth floor | 4 (6%) | 0 (0%) | |
Retromolar trigone | 2 (3%) | 0 (0%) | |
Level of lymphadenopathy | 0.290 | ||
I | 23 (33%) | 20 (55%) | |
II | 21 (31%) | 5 (14%) | |
III | 10 (15%) | 4 (11%) | |
IV | 4 (6%) | 2 (6%) | |
V | 6 (9%) | 2 (6%) | |
VI | 4 (6%) | 3 (8%) | |
Sonographic feature of lymphadenopathy | |||
Short axis (cm) | 1.28 ± 0.56 | 0.67 ± 0.33 | <0.001 * |
Long axis (cm) | 1.92 ± 0.93 | 1.17 ± 0.57 | <0.001 * |
S/L | 0.69 ± 0.15 | 0.60 ± 0.18 | 0.003 * |
Margin | <0.001 * | ||
Clear | 27 (40%) | 31 (86%) | |
Vague | 41 (60%) | 5 (14%) | |
Internal echogenicity | <0.001 * | ||
Homogenous | 16 (24%) | 31 (86%) | |
Heterogeneous | 52 (76%) | 5 (14%) | |
Echogenicity | 0.795 | ||
Hyper or Iso | 3 (4%) | 2 (6%) | |
Hypo | 65 (96%) | 34 (94%) | |
Calcification | 0.022 * | ||
Absent | 59 (87%) | 36 (100%) | |
Present | 9 (13%) | 0 (0%) | |
Architecture | 0.126 | ||
Cystic | 16 (24%) | 4 (11%) | |
Solid | 52 (76%) | 32 (89%) | |
Echogenic hilum | <0.001 * | ||
Absent | 64 (94%) | 21 (58%) | |
Present | 4 (6%) | 15 (42%) | |
Vascular pattern | 0.013 * | ||
Hilar or avascular | 53 (79%) | 35 (97%) | |
Other | 14 (21%) | 1 (3%) |
Diagnostic Examinations | Definite Diagnosis | Sensitivity (95% CI) | Specificity (95% CI) | Accuracy (95% CI) | OR (95% CI) | ||
---|---|---|---|---|---|---|---|
Malignancy | Benignity | p-Value | |||||
MRI/CT result | 79.4% (69.8–89.0%) | 86.1% (74.8–97.4%) | 81.7% (74.3–89.2%) | 23.9 (7.9–72.7) | |||
Malignancy | 54 (79%) | 5 (14%) | <0.001 * | ||||
Benignity | 14 (21%) | 31 (86%) | |||||
Post-RT US predictive model † result | 92.7% (86.4–98.9%) | 75.0% (60.9–89.1%) | 86.5% (80.0–93.1%) | 37.8 (11.6–123.3) | |||
Malignancy (score ≥ 7) | 63 (93%) | 9 (25%) | <0.001 * | ||||
Benignity (score < 7) | 5 (7%) | 27 (75%) | |||||
US + FNA result | 98.5% (95.7–100%) | 86.1% (74.8–97.4%) | 94.2% (89.7–98.7%) | 415.4 (46.5–3707.4) | |||
Malignancy | 67 (99%) | 5 (14%) | <0.001 * | ||||
Benignity | 1 (1%) | 31 (86%) |
Diagnostic Modalities | Diagnostic Result of Each Examination | Predicted Probability of Malignancy | ||
---|---|---|---|---|
MRI/CT | Post-RT US Predictive Model | US + FNA | ||
MRI/CT | Malignancy | 91.5% | ||
Benignity | 31.1% | |||
MRI/CT with a post-RT US predictive model | Malignancy | Malignancy | 96.0% | |
Benignity | Malignancy | 63.7% | ||
Malignancy | Benignity | 51.8% | ||
Benignity | Benignity | 7.3% | ||
MRI/CT with US + FNA | Malignancy | Malignancy | 100% | |
Benignity | Malignancy | 73.7% | ||
Malignancy | Benignity | 16.7% | ||
Benignity | Benignity | 0% |
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Cheng, P.-C.; Chang, C.-M.; Liao, L.-J.; Hsieh, C.-H.; Shueng, P.-W.; Cheng, P.-W.; Lo, W.-C. Ultrasound Is Beneficial to Determine Lymphadenopathy in Oral Cancer Patients after Radiotherapy. Diagnostics 2023, 13, 2409. https://doi.org/10.3390/diagnostics13142409
Cheng P-C, Chang C-M, Liao L-J, Hsieh C-H, Shueng P-W, Cheng P-W, Lo W-C. Ultrasound Is Beneficial to Determine Lymphadenopathy in Oral Cancer Patients after Radiotherapy. Diagnostics. 2023; 13(14):2409. https://doi.org/10.3390/diagnostics13142409
Chicago/Turabian StyleCheng, Ping-Chia, Chih-Ming Chang, Li-Jen Liao, Chen-Hsi Hsieh, Pei-Wei Shueng, Po-Wen Cheng, and Wu-Chia Lo. 2023. "Ultrasound Is Beneficial to Determine Lymphadenopathy in Oral Cancer Patients after Radiotherapy" Diagnostics 13, no. 14: 2409. https://doi.org/10.3390/diagnostics13142409