Cervical lymph node metastasis (radiologic criteria)

Cervical lymph node metastases refer to regional nodal involvement by cancer in the head and neck, most commonly due to squamous cell carcinoma originating from the aerodigestive tract or skin. Radiologic detection of cervical lymph node metastases is important for clinical staging and planning of surgery and radiotherapy.

Radiographic features

CT and MR

Various criteria have been proposed to predict metastatic involvement of a cervical lymph node on CT and MR:

  • short-axis diameter in axial plane ≥10 mm, except 1
    • ≥11 mm in level II (subdigastric region) 1
    • ≥5 mm in the lateral retropharyngeal group 2
    • any visible in the medial retropharyngeal group 2
  • cluster of three or more borderline nodes (each ≥8 mm short-axis diameter, except >9 mm in the level II/subdigastric region) 1
  • long-to-short axis ratio <2 (i.e. rounder) 3
  • necrotic/cystic areas (low attenuation on CT, low signal intensity on MR, hypoenhancing) 1,2
  • evidence of extranodal extension, including indistinct nodal margins, irregular nodal capsular enhancement, and infiltration into adjacent fat or muscle
PET
  • intense 18F-FDG uptake

See also

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Article information

rID: 66437
System: Head & Neck
Section: Approach
Synonyms or Alternate Spellings:

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