Diagnostic accuracy of multislice CT scan in the detection of cervical lymph node metastasis in head and neck squamous cell carcinoma taking histopathology as gold standard.

Abstract

Objective: To determine the diagnostic accuracy of multislice computed tomography (MSCT) in the detection of cervical lymph node metastasis in patients with head and neck squamous cell carcinoma, taking histopathology as the gold standard. Study Design: Cross-sectional study. Setting: Department of Radiology, Liaquat National Hospital, Karachi. Period: 31^st May 2023 to 30^th November 2023. Methods: A total of 252 patients with biopsy-proven head and neck squamous cell carcinoma were included in the study. Contrast-enhanced multislice computed tomography was performed in a craniocaudal direction. Cervical lymph nodes were considered positive for metastasis based on predefined radiological criteria. During surgery, lymph nodes were excised and sent for histopathological examination. A 2×2 contingency table was used to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy of MSCT. Post-stratification analysis was also performed. Results: Among the study population, 70.2% were male and 29.8% were female. Central necrosis was observed in 54% of lymph nodes, spherical shape in 32.9%, conglomeration of three or more lymph nodes in 34.1%, and extracapsular spread in 26.6% of cases. Multislice CT demonstrated a sensitivity of 93.8%, specificity of 95.1%, PPV of 95.3%, NPV of 93.6%, and an overall diagnostic accuracy of 94.4%. Conclusion: Multislice computed tomography showed high sensitivity, specificity, and diagnostic accuracy for detecting cervical lymph node metastasis in head and neck squamous cell carcinoma, supporting its role as a reliable preoperative imaging modality.