Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries

Rikke Norling; Cai Grau; Michael B Nielsen; Preben Homøe; Jens Sørensen; Karin Lambertsen; Troels Bundgaard; Antti Mäkitie; Reidar Grénman; Jussi Larenne; Petri Koivunen; Jukka Virtaniemi; Arnar Gudjonsson; Olav Jetlund; Helmut Abendstein; Oddveig Rikardsen; Stein Lybak; Johan Wennerberg; Anders Högmo; Göran Laurell; Anders Westerborn; Eva Hammerlid; Wieslaw Tytor; Lena Cederblad; Christian von Buchwald

doi:10.3109/0284186x.2011.640346

Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries

Rikke Norling, Cai Grau, Michael B Nielsen, Preben Homøe, Jens Sørensen, Karin Lambertsen, Troels Bundgaard, Antti Mäkitie, Reidar Grénman, Jussi Larenne, Petri Koivunen, Jukka Virtaniemi, Arnar Gudjonsson, Olav Jetlund, Helmut Abendstein, Oddveig Rikardsen, Stein Lybak, Johan Wennerberg, Anders Högmo, Göran LaurellAnders Westerborn, Eva Hammerlid, Wieslaw Tytor, Lena Cederblad, Christian von Buchwald

9 Citations (Scopus)

Abstract

Background. Fast and accurate work-up is crucial to ensure the best possible treatment and prognosis for patients with head and neck cancer. The presence or absence of neck lymph node metastases is important for the prognosis and the choice of treatment. Clinical lymph node (N)-staging is done by palpation and diagnostic imaging of the neck. We investigated the current practice of the initial radiological work-up of patients with oral squamous cell carcinomas (OSCC) in the Nordic countries. Methods. A questionnaire regarding the availability and use of guidelines and imaging modalities for radiological N-staging in OSCC was distributed to 21 Head and Neck centres in Denmark (n = 4), Finland (n = 5), Iceland (n = 1), Norway (n = 4) and Sweden (n = 7). We also asked for a description of the radiological criteria for determining the lymph nodes as clinical positive (cN+) or negative (cN0). Results. All 21 Head and Neck centres responded to the questionnaire. Denmark and Finland have national guidelines, while Norway and Sweden have local or regional guidelines. Seventeen of the 19 centres with available guidelines recommended computed tomography (CT) of the cN0 neck. The waiting time may influence the imaging modalities used. Lymph node size was the most commonly used criteria for radiological cN+, but the cut-off measures vary from 0.8 to 2.0 cm. Conclusion. Overall, CT is the most commonly recommended and used imaging modality for OSCC. Despite availability of national guidelines the type and number of radiological examinations vary between centres within a country, but the implementation of a fast-track programme may facilitate fast access to imaging. The absence of uniform criteria for determining the lymph nodes of the neck as cN+ complicates the comparison of the accuracy of the imaging modalities. Well-defined radiological strategies and criteria are needed to optimise the radiological work-up in OSCC.

Original language	English
Journal	Acta Oncologica
Volume	51
Issue number	3
Pages (from-to)	355-361
ISSN	0284-186X
DOIs	https://doi.org/10.3109/0284186x.2011.640346
Publication status	Published - Mar 2012

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Norling, R., Grau, C., Nielsen, M. B., Homøe, P., Sørensen, J., Lambertsen, K., Bundgaard, T., Mäkitie, A., Grénman, R., Larenne, J., Koivunen, P., Virtaniemi, J., Gudjonsson, A., Jetlund, O., Abendstein, H., Rikardsen, O., Lybak, S., Wennerberg, J., Högmo, A., ... von Buchwald, C. (2012). Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries. Acta Oncologica, 51(3), 355-361. https://doi.org/10.3109/0284186x.2011.640346

Norling, R, Grau, C, Nielsen, MB , Homøe, P, Sørensen, J, Lambertsen, K, Bundgaard, T, Mäkitie, A, Grénman, R, Larenne, J, Koivunen, P, Virtaniemi, J, Gudjonsson, A, Jetlund, O, Abendstein, H, Rikardsen, O, Lybak, S, Wennerberg, J, Högmo, A, Laurell, G, Westerborn, A, Hammerlid, E, Tytor, W, Cederblad, L & von Buchwald, C 2012, 'Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries', Acta Oncologica, vol. 51, no. 3, pp. 355-361. https://doi.org/10.3109/0284186x.2011.640346

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title = "Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries",

abstract = "Background. Fast and accurate work-up is crucial to ensure the best possible treatment and prognosis for patients with head and neck cancer. The presence or absence of neck lymph node metastases is important for the prognosis and the choice of treatment. Clinical lymph node (N)-staging is done by palpation and diagnostic imaging of the neck. We investigated the current practice of the initial radiological work-up of patients with oral squamous cell carcinomas (OSCC) in the Nordic countries. Methods. A questionnaire regarding the availability and use of guidelines and imaging modalities for radiological N-staging in OSCC was distributed to 21 Head and Neck centres in Denmark (n = 4), Finland (n = 5), Iceland (n = 1), Norway (n = 4) and Sweden (n = 7). We also asked for a description of the radiological criteria for determining the lymph nodes as clinical positive (cN+) or negative (cN0). Results. All 21 Head and Neck centres responded to the questionnaire. Denmark and Finland have national guidelines, while Norway and Sweden have local or regional guidelines. Seventeen of the 19 centres with available guidelines recommended computed tomography (CT) of the cN0 neck. The waiting time may influence the imaging modalities used. Lymph node size was the most commonly used criteria for radiological cN+, but the cut-off measures vary from 0.8 to 2.0 cm. Conclusion. Overall, CT is the most commonly recommended and used imaging modality for OSCC. Despite availability of national guidelines the type and number of radiological examinations vary between centres within a country, but the implementation of a fast-track programme may facilitate fast access to imaging. The absence of uniform criteria for determining the lymph nodes of the neck as cN+ complicates the comparison of the accuracy of the imaging modalities. Well-defined radiological strategies and criteria are needed to optimise the radiological work-up in OSCC.",

author = "Rikke Norling and Cai Grau and Nielsen, {Michael B} and Preben Hom{\o}e and Jens S{\o}rensen and Karin Lambertsen and Troels Bundgaard and Antti M{\"a}kitie and Reidar Gr{\'e}nman and Jussi Larenne and Petri Koivunen and Jukka Virtaniemi and Arnar Gudjonsson and Olav Jetlund and Helmut Abendstein and Oddveig Rikardsen and Stein Lybak and Johan Wennerberg and Anders H{\"o}gmo and G{\"o}ran Laurell and Anders Westerborn and Eva Hammerlid and Wieslaw Tytor and Lena Cederblad and {von Buchwald}, Christian",

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doi = "10.3109/0284186x.2011.640346",

language = "English",

volume = "51",

pages = "355--361",

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TY - JOUR

T1 - Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries

AU - Norling, Rikke

AU - Grau, Cai

AU - Nielsen, Michael B

AU - Homøe, Preben

AU - Sørensen, Jens

AU - Lambertsen, Karin

AU - Bundgaard, Troels

AU - Mäkitie, Antti

AU - Grénman, Reidar

AU - Larenne, Jussi

AU - Koivunen, Petri

AU - Virtaniemi, Jukka

AU - Gudjonsson, Arnar

AU - Jetlund, Olav

AU - Abendstein, Helmut

AU - Rikardsen, Oddveig

AU - Lybak, Stein

AU - Wennerberg, Johan

AU - Högmo, Anders

AU - Laurell, Göran

AU - Westerborn, Anders

AU - Hammerlid, Eva

AU - Tytor, Wieslaw

AU - Cederblad, Lena

AU - von Buchwald, Christian

PY - 2012/3

Y1 - 2012/3

N2 - Background. Fast and accurate work-up is crucial to ensure the best possible treatment and prognosis for patients with head and neck cancer. The presence or absence of neck lymph node metastases is important for the prognosis and the choice of treatment. Clinical lymph node (N)-staging is done by palpation and diagnostic imaging of the neck. We investigated the current practice of the initial radiological work-up of patients with oral squamous cell carcinomas (OSCC) in the Nordic countries. Methods. A questionnaire regarding the availability and use of guidelines and imaging modalities for radiological N-staging in OSCC was distributed to 21 Head and Neck centres in Denmark (n = 4), Finland (n = 5), Iceland (n = 1), Norway (n = 4) and Sweden (n = 7). We also asked for a description of the radiological criteria for determining the lymph nodes as clinical positive (cN+) or negative (cN0). Results. All 21 Head and Neck centres responded to the questionnaire. Denmark and Finland have national guidelines, while Norway and Sweden have local or regional guidelines. Seventeen of the 19 centres with available guidelines recommended computed tomography (CT) of the cN0 neck. The waiting time may influence the imaging modalities used. Lymph node size was the most commonly used criteria for radiological cN+, but the cut-off measures vary from 0.8 to 2.0 cm. Conclusion. Overall, CT is the most commonly recommended and used imaging modality for OSCC. Despite availability of national guidelines the type and number of radiological examinations vary between centres within a country, but the implementation of a fast-track programme may facilitate fast access to imaging. The absence of uniform criteria for determining the lymph nodes of the neck as cN+ complicates the comparison of the accuracy of the imaging modalities. Well-defined radiological strategies and criteria are needed to optimise the radiological work-up in OSCC.

AB - Background. Fast and accurate work-up is crucial to ensure the best possible treatment and prognosis for patients with head and neck cancer. The presence or absence of neck lymph node metastases is important for the prognosis and the choice of treatment. Clinical lymph node (N)-staging is done by palpation and diagnostic imaging of the neck. We investigated the current practice of the initial radiological work-up of patients with oral squamous cell carcinomas (OSCC) in the Nordic countries. Methods. A questionnaire regarding the availability and use of guidelines and imaging modalities for radiological N-staging in OSCC was distributed to 21 Head and Neck centres in Denmark (n = 4), Finland (n = 5), Iceland (n = 1), Norway (n = 4) and Sweden (n = 7). We also asked for a description of the radiological criteria for determining the lymph nodes as clinical positive (cN+) or negative (cN0). Results. All 21 Head and Neck centres responded to the questionnaire. Denmark and Finland have national guidelines, while Norway and Sweden have local or regional guidelines. Seventeen of the 19 centres with available guidelines recommended computed tomography (CT) of the cN0 neck. The waiting time may influence the imaging modalities used. Lymph node size was the most commonly used criteria for radiological cN+, but the cut-off measures vary from 0.8 to 2.0 cm. Conclusion. Overall, CT is the most commonly recommended and used imaging modality for OSCC. Despite availability of national guidelines the type and number of radiological examinations vary between centres within a country, but the implementation of a fast-track programme may facilitate fast access to imaging. The absence of uniform criteria for determining the lymph nodes of the neck as cN+ complicates the comparison of the accuracy of the imaging modalities. Well-defined radiological strategies and criteria are needed to optimise the radiological work-up in OSCC.

U2 - 10.3109/0284186x.2011.640346

DO - 10.3109/0284186x.2011.640346

M3 - Journal article

C2 - 22175252

SN - 1100-1704

VL - 51

SP - 355

EP - 361

JO - Acta Oncologica, Supplement

JF - Acta Oncologica, Supplement

IS - 3

ER -

Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries

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