Ultrasound in the Re-Staging of Cervical Metastases after Chemoradiotherapy for Head and Neck Cancer

Julian Künzel; Sebastian Strieth; Gesine Wirth; Alessandro Bozzato

doi:10.1055/a-0573-0908

Ultraschall in der Medizin - European Journal of Ultrasound, Table of Contents

Ultraschall Med 2018; 39(06): 659-666
DOI: 10.1055/a-0573-0908

Review

Ultrasound in the Re-Staging of Cervical Metastases after Chemoradiotherapy for Head and Neck Cancer

Ultraschall zum Re-Staging cervikaler Metastasen nach primärer Radiochemotherapie von Kopf- und Halskarzinomen

Julian Künzel

¹Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Mainz, Mainz, Germany

,

Sebastian Strieth

¹Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Mainz, Mainz, Germany

,

Gesine Wirth

²Department of Neuroradiology, University Hospital of Mainz, Mainz, Germany

,

Alessandro Bozzato

³Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Saarlanddical School, Homburg, Germany

› Author Affiliations

Abstract

High-resolution ultrasonography, including color duplex modes, is a well-established and proven imaging method that is used in addition to computed tomography for re-staging after primary nonsurgical therapy for head and neck cancer in many European countries. No evidence-based international re-staging guidelines are available. Decisions as to whether to carry out neck dissection after primary radiotherapy or chemoradiotherapy are often made in the relevant tumor boards and are therefore subject to variance. High-resolution ultrasonography clearly detects morphological changes such as intranodal necrotic areas and alterations in the hilar vascularization pattern. Another important aspect of ultrasonography is that it allows accurate check-ups on dynamic changes during the follow-up period. This article reviews the role of ultrasonography in the follow-up and re-staging of patients with neck disease after primary chemoradiotherapy.

Zusammenfassung

Die hochauflösende Sonografie inklusive Farbduplex in Kombination mit der Computertomografie (CT) ist in vielen europäischen Ländern eine gut etablierte und verlässliche Methode für das Re-Staging nach primär nicht-chirurgischer Therapie von Kopf- und Halskarzinomen. Es existieren jedoch keine international gültigen Leitlinien in Bezug auf das Re-Staging. Daher wird die Entscheidung zur Neck dissektion (ND) nach primärer Radio- oder Radiochemotherapie (RCT) oftmals in den entsprechenden Tumorboards getroffen. Die Indikationen unterliegen aber einer gewissen Variabilität. Die hochauflösende Sonografie ist besonders geeignet um morphologische Veränderungen intranodale Nekrosen und Veränderungen des hilären Vaskularisationsmusters eindeutig darzustellen. Ein weiterer wichtiger Aspekt der sonografischen Tumornachsorge ist die akkurate Kontrolle dynamischer Veränderungen. Im Rahmen dieses Übersichtsartikels soll die Rolle des Ultraschalls in der Nachsorge der Halslymphknoten nach abgeschlossener RCT eingeordnet werden.

Key words

ultrasound - follow-up - solbiati index - re-staging - neck dissection

Full Text

References

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