Chapter 2. Squamous Cell Carcinoma of the Head and Neck: Imaging Evaluation of Regional Lymph Nodes and Implications for Management

• Published in: Seminars in ultrasound, CT, and MRI CT, and MRI, 2017-10, Vol.38 (5), p.466-478
• Main Authors: Kelly, Hillary R, Curtin, Hugh D
• Format: Article
• Language: English
• Subjects: Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - pathology; Diagnostic Imaging - methods; Head and Neck Neoplasms - diagnostic imaging; Head and Neck Neoplasms - pathology; Humans; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Metastasis; Neck - diagnostic imaging; Neck - pathology; Radiology; Squamous Cell Carcinoma of Head and Neck
• ISSN: 0887-2171; 1558-5034
• DOI: 10.1053/j.sult.2017.05.003

Abstract The presence of cervical lymph node metastases is a major prognostic factor in squamous cell carcinoma of the head and neck (HNSCC). The presence of a solitary ipsilateral metastatic lymph node reduces expected survival by almost 50%, and the presence of regional metastatic nodes at the time of presentation is the strongest predictor of recurrence and/or the development of distant metastases. Therefore, accurate identification of metastatic cervical lymph nodes is essential for staging and treatment planning. Pretreatment imaging is important for identifying clinically occult pathologic nodes as well as delineating nodal size and morphologic characteristics used in staging. The role of imaging and its implications for management are reviewed, with emphasis on the traditional modalities and imaging criteria, including evaluation for extranodal extension.