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Michiel W. M. van den Brekel, MD; Jonas A. Castelijns, MD, PhD; Gerard A. Croll, MD; Herbert V. Stel, MD, PhD; Jaap Valk, MD, PhD; Isaäk van der Waal, DD, PhD; Richard P. Golding, FRCR; Chris J. L. M. Meyer, MD, PhD; Gordon B. Snow, MD, PhD

Arch Otolaryngol Head Neck Surg. 1991;117(6):666-673.

Abstract
• In a series of 100 patients with head and neck carcinoma, the preoperative histopathologic findings of palpation and magnetic resonance imaging were compared with regard to both laterality and lymph node level (I through V). The overall error for palpation in detecting affected sides was 32%. Gadolinium-enhanced magnetic resonance images reliably upgraded 60% of the clinically negative necks, the overall error of magnetic resonance imaging being 16%. However, for both modalities, the sensitivity per level was too low to allow for selective neck dissections in case of only one positive level. These findings show that apart from primary tumor grading, magnetic resonance imaging can improve the preoperative grading of cervical lymph nodes. In selected cases, this may change the treatment plan to a "wait-and-see" policy or a more conservative type of neck dissection.

(Arch Otolaryngol Head Neck Surg. 1991; 117:666-673)

Author Affiliations
From the Departments of Otorhinolaryngology—Head and Neck Surgery (Drs van den Brekel, Croll, and Snow), Radiology (Drs Castelijns, Valk, and Golding), Pathology (Drs Stel and Meyer), and Oral Pathology (Dr van der Waal), Free University Hospital, Amsterdam, the Netherlands.

Footnotes
Accepted for publication November 26, 1990.

Reprint requests to Department of Otorhinolaryngology—Head and Neck Surgery, Free University Hospital, PO Box 7057, 1007 MB Amsterdam, the Netherlands (Dr van den Brekel).

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