REGIONAL METASTASIS IN HEAD AND NECK SQUAMOUS-CELL CARCINOMA - REVISED VALUE OF US WITH US-GUIDED FNAB

PURPOSE: To verify the acclaimed accuracy of ultrasound (US) combined with US-guided fine-needle aspiration biopsy (FNAB) in the detection o f lymph node metastasis in the neck and to evaluate the interobserver variability. MATERIALS AND METHODS: In a prospective, multicenter stud y of 185 patients with head and neck squamous cell carcinoma, US (n = 238 neck sides) with US-guided FNAB (n = 178 neck sides) was used for evaluation of the lymph node status of the neck. Findings were correla ted with those of histopathologic examination in 238 neck sides. RESUL TS: US with US-guided FNAB had a sensitivity of 77% and a specificity of 100%. Nineteen of 178 aspirations were nondiagnostic. There were no significant differences between the four participating hospitals or t he individual sonologists (P >.05). CONCLUSION: Sensitivity of US with US-guided FNAB was slightly lower compared with previous reports. Spe cificity was similar to previous reports. Interobserver variability ap peared to be low. The validity of US with US-guided FNAB is high and w arrants widespread use of the procedure for evaluation of the neck.