Ultrasonography and computed tomography of extracapsular invasion in cervical lymph nodes of squamous cell carcinoma in the oral cavity

Purpose This study evaluates the efficacy of imaging for diagnosing extracapsular invasion by metastatic cervical lymph nodes.Methods The subjects were 47 patients with squamous cell carcinoma of the oral cavity examined by both ultrasonography and computed tomography. All subjects had undergone neck dissection, and histopathologic examination confirmed the presence of one or more metastatic cervical lymph nodes in each of them.Results Histopathologic examination confirmed extracapsular invasion in 25 of 48 metastatic nodes; in the remaining 23 nodes, the tumor was confined within the capsule. Average short-axis diameters of the lymph nodes of these groups differed significantly (17.4 ± 10.6 and 12.7 ± 4.4 mm, respectively; P = 0.046). The diagnostic sensitivity, specificity, and accuracy of ultrasonography for detecting macroscopic extracapsular invasion were 80%, 74%, and 77%, respectively. The corresponding values for computed tomography were 85%, 83%, and 84%.Conclusion Diagnostic images are effective for the preoperative diagnosis of extracapsular invasion of metastatic cervical nodes of carcinoma of the oral cavity.