Diagnostic accuracy of computed tomography for cervical metastases at different anatomical levels in carcinoma of the tongue

Objectives: To evaluate the variation in diagnostic accuracy of CT in the a ssessment of cervical lymph node metastases from tongue carcinoma at differ ent anatomical levels. Methods: Sixty-one patients with squamous cell carcinoma of the tongue who underwent radical neck dissection were included in this study. The CT and h istopathological findings at nodal levels I-V were compared for the presenc e or absence of lymph node metastases. Sensitivity, specificity, negative p redictive value (NPV) and positive predictive value (PPV) of CT were evalua ted for each nodal level. Results: The sensitivity of CT was: level I, 85%; level II, 77.8%; level II I, 53.3%; level IV, 66.7% and level V, 25%. There was a significant differe nce in the sensitivity between the level I-II group (80.9%) and level III-V group (53.6%) (P=0.012). There was no significant difference in the specif icity, NPV, and PPV between the two groups. Conclusions: The sensitivity of CT in detecting cervical lymph node metasta ses was significantly smaller at levels III-V than at levels I-II.