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Diagnostic performance of computed tomography features in detecting oropharyngeal squamous cell carcinoma extranodal extension.
Tran, Ngoc-Anh; Palotai, Miklos; Hanna, Glenn J; Schoenfeld, Jonathan D; Bay, Camden P; Rettig, Eleni M; Bunch, Paul M; Juliano, Amy F; Kelly, Hillary R; Suh, Chong Hyun; Zander, David A; Morales Pinzon, Alfredo; Kann, Benjamin H; Huang, Raymond Y; Haddad, Robert I; Guttmann, Charles R G; Guenette, Jeffrey P.
Afiliação
  • Tran NA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Palotai M; Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Hanna GJ; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
  • Schoenfeld JD; Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
  • Bay CP; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Rettig EM; Division of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
  • Bunch PM; Division of Neuroradiology, Wake Forest School of Medicine, Winston Salem, NC, USA.
  • Juliano AF; Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
  • Kelly HR; Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
  • Suh CH; Division of Neuroradiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Zander DA; Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
  • Morales Pinzon A; Division of Neuroradiology, University of Colorado, Aurora, CO, USA.
  • Kann BH; Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Huang RY; Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
  • Haddad RI; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Guttmann CRG; Division of Neuroradiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, 75 Francis Street Boston, Boston, MA, 02115, USA.
  • Guenette JP; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Eur Radiol ; 33(5): 3693-3703, 2023 May.
Article em En | MEDLINE | ID: mdl-36719493
OBJECTIVES: Accurate pre-treatment imaging determination of extranodal extension (ENE) could facilitate the selection of appropriate initial therapy for HPV-positive oropharyngeal squamous cell carcinoma (HPV + OPSCC). Small studies have associated 7 CT features with ENE with varied results and agreement. This article seeks to determine the replicable diagnostic performance of these CT features for ENE. METHODS: Five expert academic head/neck neuroradiologists from 5 institutions evaluate a single academic cancer center cohort of 75 consecutive HPV + OPSCC patients. In a web-based virtual laboratory for imaging research and education, the experts performed training on 7 published CT features associated with ENE and then independently identified the "single most (if any) suspicious" lymph node and presence/absence of each of the features. Inter-rater agreement was assessed using percentage agreement, Gwet's AC1, and Fleiss' kappa. Sensitivity, specificity, and positive and negative predictive values were calculated for each CT feature based on histologic ENE. RESULTS: All 5 raters identified the same node in 52 cases (69%). In 15 cases (20%), at least one rater selected a node and at least one rater did not. In 8 cases (11%), all raters selected a node, but at least one rater selected a different node. Percentage agreement and Gwet's AC1 coefficients were > 0.80 for lesion identification, matted/conglomerated nodes, and central necrosis. Fleiss' kappa was always < 0.6. CT sensitivity for histologically confirmed ENE ranged 0.18-0.94, specificity 0.41-0.88, PPV 0.26-0.36, and NPV 0.78-0.96. CONCLUSIONS: Previously described CT features appear to have poor reproducibility among expert head/neck neuroradiologists and poor predictive value for histologic ENE. KEY POINTS: • Previously described CT imaging features appear to have poor reproducibility among expert head and neck subspecialized neuroradiologists as well as poor predictive value for histologic ENE. • Although it may still be appropriate to comment on the presence or absence of these CT features in imaging reports, the evidence indicates that caution is warranted when incorporating these features into clinical decision-making regarding the likelihood of ENE.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Orofaríngeas / Infecções por Papillomavirus / Neoplasias de Cabeça e Pescoço Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Orofaríngeas / Infecções por Papillomavirus / Neoplasias de Cabeça e Pescoço Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article