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

Norling, Rikke; Grau, Cai; Nielsen, Michael B.; Homoe, Preben; Sorensen, Jens A.; Lambertsen, Karin; Bundgaard, Troels; Makitie, Antti; Grenman, Reidar and Larenne, Jussi, et al. (2012) In Acta Oncologica 51(3). p.355-361
Abstract
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... (More)
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. (Less)
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Contribution to journal
publication status
published
subject
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Acta Oncologica
volume
51
issue
3
pages
355 - 361
publisher
Taylor & Francis
external identifiers
  • wos:000302731800010
  • scopus:84859736988
ISSN
1651-226X
DOI
10.3109/0284186X.2011.640346
language
English
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yes
id
abf52edb-af0a-4420-a453-39b51629d342 (old id 2571205)
date added to LUP
2012-06-01 08:55:03
date last changed
2017-04-23 03:56:11
@article{abf52edb-af0a-4420-a453-39b51629d342,
  abstract     = {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.},
  author       = {Norling, Rikke and Grau, Cai and Nielsen, Michael B. and Homoe, Preben and Sorensen, Jens A. and Lambertsen, Karin and Bundgaard, Troels and Makitie, Antti and Grenman, Reidar and Larenne, Jussi and Koivunen, Petri and Virtaniemi, Jukka and Gudjonsson, Arnar and Jetlund, Olav and Abendstein, Helmut and Rikardsen, Oddveig and Lybak, Stein and Wennerberg, Johan and Hogmo, Anders and Laurell, Goran and Westerborn, Anders and Hammerlid, Eva and Tytor, Wieslaw and Cederblad, Lena and von Buchwald, Christian},
  issn         = {1651-226X},
  language     = {eng},
  number       = {3},
  pages        = {355--361},
  publisher    = {Taylor & Francis},
  series       = {Acta Oncologica},
  title        = {Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries},
  url          = {http://dx.doi.org/10.3109/0284186X.2011.640346},
  volume       = {51},
  year         = {2012},
}