Cervical nodal metastases are common in patients with head and neck cancers. Early assessment is important for treatment planning and prognosis. Ultrasound has been widely used in the evaluation of neck lymph nodes, with common parameters including location, size, shape, boundary, hilus, echogenicity, vascular pattern, and resistance index. The diagnostic accuracy has been dramatically improved along with the introduction of new techniques including contrast-enhanced ultrasound, elastography, and ultrasound-guided fine needle aspiration biopsy. Neck ultrasound has became an important tool in preoperative assessment and postoperative follow-up for patients with head and neck cancers.
Head and Neck Neoplasms ; pathology ; Humans ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; diagnostic imaging ; pathology ; Neck ; diagnostic imaging ; pathology ; Ultrasonography

Diagnostic Errors ; Female ; Femoral Neck Fractures ; diagnosis ; diagnostic imaging ; Femur Neck ; diagnostic imaging ; injuries ; Humans ; Radiography ; Young Adult

OBJECTIVEUsing radioactive nano tracer with different sizes (average diameter were 50, 80 and 100 nm) and dosages (0.01 and 0.02 ml) in the thyroids of rabbits, to study the drainage of thyroid to cervical lymph nodes (LNs) in rabbits and to provide experimental evidence for the choice of ideal sizes and dosages of radioactive Nano tracer for the sentinel lymph node biopsy (SLNB) in thyroid cancer patients.

METHODSThirty adult rabbits were randomly divided into six groups (50 nm - 0.01 ml, 50 nm - 0.02 ml, 80 nm - 0.01 ml, 80 nm - 0.02 ml, 100 nm - 0.01 ml, 100 nm - 0.02 ml of (99m)Tc-Sb(2)S(3)) with five rabbits in each group. A total of 60 sides of thyroids were included. The mean number of LNs with radioactivity, the initial, the strangest and the lasting time of radioactivity in LNs in each group were measured.

RESULTSOne to three LNs were identified in one side neck of rabbits, totally 86 LNs. Most of LNs with radioactivity existed in level VI, counting for 75.6% (65/86). (99m)Tc-Sb(2)S(3) with 50 nm particles was significantly better than that with 80 nm or 100 nm particles with regarding the initial and the strangest radioactive time of (99m)Tc-Sb(2)S(3) in LNs (P < 0.05). There were no significant difference in the mean number of LNs with radioactivity, the initial, the strangest and the lasting time of radioactivity between the dosages of 0.01 ml and 0.02 ml of (99m)Tc-Sb(2)S(3) with same size of particles (P > 0.05).

CONCLUSION(99m)Tc-Sb(2)S(3) with 50 nm particles, in the dosage of 0.01 ml or 0.02 ml, could be good choice for SLNB of thyroid cancer.

Animals ; Lymph Nodes ; diagnostic imaging ; Male ; Nanostructures ; Neck ; diagnostic imaging ; Rabbits ; Radioactive Tracers ; Radionuclide Imaging ; Thyroid Gland ; diagnostic imaging

Adult ; Choristoma ; diagnostic imaging ; Female ; Head and Neck Neoplasms ; diagnostic imaging ; Humans ; Thymoma ; diagnostic imaging ; Tomography, Spiral Computed

Branchioma ; diagnostic imaging ; surgery ; Contrast Media ; administration & dosage ; Head and Neck Neoplasms ; diagnostic imaging ; surgery ; Humans ; Radiography

OBJECTIVETo investigate the feasibility of differentiation of lymphoma, metastatic lymph nodes of squamous cell carcinoma (SCC) and papillary thyroid carcinoma (PTC) in the head and neck by single-source dual-energy spectral CT.

METHODS25 cases of non-Hodgkin lymphoma (NHL) with 236 lymph nodes, 3 cases of Hodgkin's lymphoma (HL) with 32 lymph nodes, 21 cases of SCC with 86 lymph nodes and 19 cases of PTC with 92 lymph nodes were evaluated by enhanced GSI. CT attenuation of lymph nodes in the monochromatic images at different keV levels and the iodine and water contents of these lymph nodes were measured. The slope of spectral curve was calculated using CT value at 40 keVand 90 keV. All results were analyzed with ANOVA and t test.

RESULTS70 keV had the best single energy images. Normalized Hounsfield unit (NHU) of diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), T lymphoblastic lymphoma (T-LBL), HL, PTC and SCC was 0.32 ± 0.10, 0.46 ± 0.08, 0.41 ± 0.11, 0.41 ± 0.11, 0.56 ± 0.15 and 0.34 ± 0.16, respectively. Normalized iodine concentration (NIC) of them was 0.20 ± 0.08, 0.32 ± 0.08, 0.25 ± 0.09, 0.30 ± 0.12, 0.49 ± 0.18 and 0.23 ± 0.18, respectively. The slope of spectral curve (k) of them was -1.92 ± 0.55, -2.45 ± 0.60, -1.82 ± 0.57, -2.57 ± 0.54, -5.44 ± 2.41 and -1.97 ± 0.81, respectively. Compared with the NHU, there was a statistically significant difference in each pair except DLBCL and SCC, and T-LBL and HL. Compared with the NIC, there was a statistically significant difference in each pair except DLBCL and SCC, FL and HL, T-LBL and SCC, and T-LBL and HL. Compared with the slope of spectral curve, there was statistically significant difference in each pair except DLBCL and T-LBL, DLBCL and SCC, FL and HL, and T-LBL and SCC.

CONCLUSIONSMalignant lymph nodes of different types of diseases have certain different values of quantitative parameters in spectral CT imaging. By using CT attenuation, the shape and slope of spectral curve and the iodine content, single-source dual-energy CT may potentially provide a quantitative analysis tool for the diagnosis and differential diagnosis of lymph node alterations.

Carcinoma ; diagnostic imaging ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; diagnostic imaging ; Diagnosis, Differential ; Head and Neck Neoplasms ; diagnostic imaging ; Hodgkin Disease ; diagnostic imaging ; Humans ; Lymph Nodes ; diagnostic imaging ; Lymphoma ; diagnostic imaging ; Lymphoma, Follicular ; diagnostic imaging ; Lymphoma, Large B-Cell, Diffuse ; diagnostic imaging ; Lymphoma, Non-Hodgkin ; diagnostic imaging ; Neck ; Thyroid Neoplasms ; diagnostic imaging ; Tomography, X-Ray Computed

This paper introduces the constitution and fabrication of the new head and neck stereotactic conformal radiotherapy system. It remedies the shortages in the head and neck stereotactic conformal radiotherapy at present and it is deserved to be popularized in clinical applications.
Equipment Design ; Head ; diagnostic imaging ; surgery ; Head and Neck Neoplasms ; diagnostic imaging ; surgery ; Humans ; Neck ; diagnostic imaging ; surgery ; Radiography ; Radiosurgery ; instrumentation ; Radiotherapy, Conformal ; instrumentation

The importance of routine neck ultrasonography for the detection of unsuspected local or nodal recurrence of thyroid cancer following thyroidectomy (with or without neck dissection) is well documented in many journal articles and international guidelines. Herein, we present a pictorial summary of the sonographic features of benign and malignant central neck compartment nodules and cervical lymph nodes via a series of high-quality ultrasonographic images, with a review of the literature.
Female ; Humans ; Male ; Neck ; diagnostic imaging ; surgery ; Neck Dissection ; Singapore ; Thyroid Neoplasms ; diagnostic imaging ; surgery ; Thyroid Nodule ; diagnostic imaging ; Thyroidectomy ; methods ; Ultrasonography

The parapharyngeal space (PPS) is an inverted pyramid-shaped deep space in the head and neck region, and a variety of tumors, such as salivary gland tumors, neurogenic tumors, nasopharyngeal carcinomas with parapharyngeal invasion, and lymphomas, can be found in this space. The differential diagnosis of PPS tumors remains challenging for radiologists. This study aimed to develop and test a modified method for locating PPS tumors on magnetic resonance (MR) images to improve preoperative differential diagnosis. The new protocol divided the PPS into three compartments: a prestyloid compartment, the carotid sheath, and the areas outside the carotid sheath. PPS tumors were located in these compartments according to the displacements of the tensor veli palatini muscle and the styloid process, with or without blood vessel separations and medial pterygoid invasion. This protocol, as well as a more conventional protocol that is based on displacements of the internal carotid artery (ICA), was used to assess MR images captured from a series of 58 PPS tumors. The consequent distributions of PPS tumor locations determined by both methods were compared. Of all 58 tumors, our new method determined that 57 could be assigned to precise PPS compartments. Nearly all (13/14; 93%) tumors that were located in the pre-styloid compartment were salivary gland tumors. All 15 tumors within the carotid sheath were neurogenic tumors. The vast majority (18/20; 90%) of trans-spatial lesions were malignancies. However, according to the ICA-based method, 28 tumors were located in the pre-styloid compartment, and 24 were located in the post-styloid compartment, leaving 6 tumors that were difficult to locate. Lesions located in both the pre-styloid and the post-styloid compartments comprised various types of tumors. Compared with the conventional ICA-based method, our new method can help radiologists to narrow the differential diagnosis of PPS tumors to specific compartments.
Carcinoma ; Diagnosis, Differential ; Humans ; Lymphoma ; diagnosis ; diagnostic imaging ; Magnetic Resonance Spectroscopy ; Nasopharyngeal Neoplasms ; diagnosis ; diagnostic imaging ; Neck ; diagnostic imaging ; Nervous System Neoplasms ; diagnosis ; diagnostic imaging ; Pharynx ; diagnostic imaging ; Radiography ; Salivary Gland Neoplasms ; diagnosis ; diagnostic imaging

Carotid Arteries ; diagnostic imaging ; surgery ; Feasibility Studies ; Head and Neck Neoplasms ; blood supply ; diagnostic imaging ; surgery ; Humans ; Radionuclide Imaging