Ultrasound elastography in the head and neck. Part II. Accuracy for malignancy.

Ultrasound elastography (USE) describes a variety of ultrasound-based imaging techniques that measure tissue stiffness properties, and is currently under intense investigation for tissue characterization in several anatomic sites. This article summarizes the evidence regarding the accuracy of USE for malignancy in the head and neck. Currently, most published data pertains to small pilot studies with varied methodologies.

Ultrasound elastography in the head and neck. Part I. Basic principles and practical aspects.

Ultrasound elastography (USE) is a rapidly developing field of imaging that measures and displays tissue elasticity or stiffness properties using ultrasound. In recent years, real-time USE modes have appeared on commercially available clinical ultrasound machines, stimulating an explosion of research into potential oncologic and non-oncologic clinical applications of USE. Preliminary evidence suggests that USE can differentiate benign and malignant conditions accurately in several different tissues.

Shear wave elastography of thyroid nodules in routine clinical practice: preliminary observations and utility for detecting malignancy.

Objective: To evaluate real-time shear wave ultrasound elastography (SWE) for characterizing focal thyroid lesions in routine clinical practice.

Methods: Seventy-four patients with 81 focal thyroid lesions undergoing conventional US with needle cytology also underwent SWE. Absolute and relative SWE stiffness measurements on colour-coded elastograms were correlated with cytology and their discriminatory performances assessed.

A pilot study evaluating real-time shear wave ultrasound elastography of miscellaneous non-nodal neck masses in a routine head and neck ultrasound clinic.

A pilot study was performed to evaluate shear wave ultrasound elastography (SWE) for miscellaneous non-nodal/salivary/thyroid neck lesions. Forty-six lesions undergoing conventional sonography also underwent SWE. Elastic moduli from the stiffest areas in lesions were correlated with diagnosis.

Shear wave elastography of focal salivary gland lesions: preliminary experience in a routine head and neck US clinic.

Objectives: To evaluate shear wave elastography (SWE) for focal lesions in major salivary glands.

Methods: Sixty lesions (49 parotid, 11 submandibular) undergoing routine ultrasound (grey scale and Doppler) also underwent SWE before US-guided needle aspiration for cytology. Quantitative indices of the shear elastic modulus (stiffness) were compared with cytological results.

Shear wave elasticity imaging of cervical lymph nodes.

A pilot study of real-time shear wave ultrasound elastography (SWE) for cervical lymphadenopathy in routine clinical practice was conducted on 55 nodes undergoing conventional ultrasound (US) with US-guided needle aspiration for cytology. Elastic moduli of stiffest regions in nodes were measured on colour-coded elastograms, which were correlated with cytology. Malignant nodes (n = 31, 56.

Nasopharyngeal cancers: which method should be used to measure these irregularly shaped tumors on cross-sectional imaging?

Purpose: To determine whether the standard techniques of measuring tumor size and change in size after treatment could be applied to the measurement of nasopharyngeal cancers, which are often irregular in shape.

Methods And Materials: The standard measurements of bidimensional (BDM) (World Health Organization criteria) and unidimensional (UDM) (Response Evaluation Criteria in Solid Tumors [RECIST] criteria), together with the maximum depth of the tumor perpendicular to the pharyngeal wall (DM), were acquired from axial magnetic resonance images of primary nasopharyngeal carcinoma in 44 patients at diagnosis and in 29 of these patients after treatment. Tumor volume measurements (VM), acquired from the summation of areas from the axial magnetic resonance images, were used as the reference standard.

Early swallowing problems in a cohort of patients with nasopharyngeal carcinoma: Symptomatology and videofluoroscopic findings.

Objective: To study the incidence and the degree of swallowing dysfunction in patients with nasopharyngeal carcinoma (NPC) who underwent radiation therapy treatment.

Institution: The study was conducted in the Prince of Wales Hospital, a tertiary teaching hospital of the Chinese University of Hong Kong.

Materials And Methods: From October 1999 to July 2001, a cohort of 20 consecutive patients with newly diagnosed NPC was prospectively studied.

Chest radiograph scores as potential prognostic indicators in severe acute respiratory syndrome (SARS).

Objective: We analyzed serial chest radiographic scores for lung opacification in patients with severe acute respiratory syndrome (SARS) for temporal changes and differences between fatal and discharged cases. We sought to establish the earliest radiographic scores sensitive as potential prognostic indicators of fatal outcomes.

Materials And Methods: Chest radiographs that had been obtained from presentation until the death or discharge of 313 patients with SARS were scored on the basis of the percentage area and location of lung opacification.

Comparison of CT and MR imaging for the detection of extranodal neoplastic spread in metastatic neck nodes.

Purpose: To compare computed tomography (CT) and magnetic resonance (MR) imaging for the detection of extranodal neoplastic spread (ENS) in metastatic cervical nodes from head and neck squamous cell carcinoma.

Materials And Methods: 17 patients with a squamous cell carcinoma of the head and neck underwent CT and MR imaging. The neck nodes were assessed for ENS and the results compared using pathology from the surgical resection.

Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration.

This study aims to compare the therapeutic effectiveness of continuous catheter drainage versus intermittent needle aspiration in the percutaneous treatment of pyogenic liver abscesses. Over a 5-year period, 64 consecutive patients with pyogenic liver abscess were treated with intravenous antibiotics (ampicillin, cefuroxime, and metronidazole) and randomized into two percutaneous treatment groups: continuous catheter drainage (with an 8F multi-sidehole pigtail catheter); and intermittent needle aspiration (18G disposable trocar needle). There was no statistically significant difference between the two groups regarding patient demographics, underlying coexisting disease, abscess size, abscess number, number of loculation of abscess, the presenting clinical symptoms such as fever, abdominal pain, and pretreatment liver function test.

Necrosis in metastatic neck nodes: diagnostic accuracy of CT, MR imaging, and US.

Purpose: To compare the diagnostic accuracy of computed tomography (CT), magnetic resonance (MR) imaging, and ultrasonography (US) in the detection of necrosis in metastatic cervical nodes from patients with head and neck squamous cell carcinoma.

Materials And Methods: Twenty-seven patients (age range, 39-85 years; mean age, 62 years) with squamous cell carcinoma in the head and neck underwent CT, MR imaging, and US. Three radiologists evaluated the images for nodal necrosis.

Non-Hodgkin lymphoma of the larynx: CT and MR imaging findings.

Background And Purpose: Non-Hodgkin lymphoma (NHL) of the larynx is a rare tumor. The aim of this study was to report the CT and MR features of laryngeal NHL in four patients to determine if there are any features that might be helpful to distinguish NHL from other laryngeal tumors.

Methods: The CT and MR images of four patients with laryngeal NHL were retrospectively reviewed for tumor volume and distribution, appearance, local invasion, and lymphadenopathy.

Thin-section CT in patients with severe acute respiratory syndrome following hospital discharge: preliminary experience.

Purpose: To report the initial experience regarding thin-section computed tomographic (CT) findings in patients with severe acute respiratory syndrome (SARS) who improved clinically after treatment.

Materials And Methods: Twenty-four patients (10 men, 14 women; mean age, 39 years; age range, 23-70 years) with confirmed SARS underwent follow-up thin-section CT of the thorax. The scans were obtained on average 36.

Severe acute respiratory syndrome: radiographic appearances and pattern of progression in 138 patients.

Purpose: To retrospectively evaluate the radiographic appearances and pattern of progression of severe acute respiratory syndrome (SARS).

Materials And Methods: Chest radiographs obtained at clinical presentation and during treatment in 138 patients with confirmed SARS (66 men, 72 women; mean age, 39 years; age range, 20-83 years) were assessed. Radiographic appearances of pulmonary parenchymal abnormality, distribution, and extent of involvement on initial chest radiographs were documented.

Thin-section CT of severe acute respiratory syndrome: evaluation of 73 patients exposed to or with the disease.

Purpose: To retrospectively analyze the thin-section computed tomographic (CT) features in patients with severe acute respiratory syndrome (SARS) at the authors' institution.

Materials And Methods: From March 11, 2003, to April 2, 2003, 74 patients with symptoms and signs suggestive of SARS underwent CT of the thorax; all underwent thin-section CT except for one patient who underwent conventional CT. Group 1 (n = 23) patients had symptoms of SARS in keeping with criteria from the Centers for Disease Control and Prevention and a positive chest radiograph.