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David D. Morrissey, MD; J. Michael Talbot, MD; James I. Cohen, MD, PhD; Mark K. Wax, MD; Peter E. Andersen, MD

Arch Otolaryngol Head Neck Surg. 2000;126:1478-1481.

Objective  To decide the accuracy of computed tomography in determining the presence or absence of metastatic retropharygeal adenopathy in patients with squamous cell carcinoma of the head and neck.

Design  A comparison of the results of retrospective blinded review of preoperative computed tomographic scans with the histologic findings of retropharyngeal node dissection at the time of surgery.

Setting  Academic tertiary care center.

Patients  Twenty-six patients with advanced stage squamous cell carcinoma of the head and neck.

Main Outcome Measures  Computed tomographic findings and histologic results of retropharyngeal node dissection.

Results  The retropharyngeal nodes were pathologically positive for metastasis in 6 (23%) of the 26 patients. The radiologist (J.M.T.) correctly read the scan in 3 of 6 patients with histologically proved metastasis, and in 14 of 20 patients with histologic features negative for metastasis. The sensitivity of the radiologist reading was 50%, and the specificity was 70%. The positive predictive value was 33%, and the negative predictive value was 82%.

Conclusion  The presence of retropharyngeal node metastasis cannot be determined by computed tomographic imaging alone.

From the Department of Otolaryngology/Head and Neck Surgery, Oregon Health Sciences University (Drs Morrissey, Cohen, Wax, and Andersen), and the East Portland Imaging Center (Dr Talbot), Portland, Ore. Dr Morrissey is now in private practice in Boulder, Colo.

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