A real‐time prediction model for post‐irradiation malignant cervical lymph nodes. (23rd October 2017)

• Record Type: Journal Article
• Authors: Lo, W.‐C.; Cheng, P.‐W.; Shueng, P.‐W.; Hsieh, C.‐H.; Chang, Y.‐L.; Liao, L.‐J.
• Is Part Of: Clinical otolaryngology. Volume 43:Number 2(2018)
• Page Start: 477
• Page End: 482
• Publication Date: 2017-10-23
• Subjects: fine‐needle aspiration biopsy -- head and neck -- lymph node -- prediction model -- radiotherapy -- ultrasound; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1111/coa.12998
• Languages: English
• ISSNs: 1749-4478

Abstract

Abstract : Objective: To establish a real‐time predictive scoring model based on sonographic characteristics for identifying malignant cervical lymph nodes (LNs) in cancer patients after neck irradiation. Methods: One‐hundred forty‐four irradiation‐treated patients underwent ultrasonography and ultrasound‐guided fine‐needle aspirations (USgFNAs), and the resultant data were used to construct a real‐time and computerised predictive scoring model. This scoring system was further compared with our previously proposed prediction model. Results: A predictive scoring model, 1.35 × (L axis) + 2.03 × (S axis) + 2.27 × (margin) + 1.48 × (echogenic hilum) + 3.7, was generated by stepwise multivariate logistic regression analysis. Neck LNs were considered to be malignant when the score was ≥ 7, corresponding to a sensitivity of 85.5%, specificity of 79.4%, positive predictive value (PPV) of 82.3%, negative predictive value (NPV) of 83.1%, and overall accuracy of 82.6%. When this new model and the original model were compared, the areas under the receiver operating characteristic curve (c‐statistic) were 0.89 and 0.81, respectively ( P < .05). Conclusions: A real‐time sonographic predictive scoring model was constructed to provide prompt and reliable guidance for USgFNA biopsies to manage cervical LNs after neck irradiation.