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Head and Neck Cancer pp 265–278Cite as

Ultrasound Investigations in Head and Neck Cancer Patients

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Abstract

The wide availability, inexpensiveness and its nonionizing nature make ultrasound an ideal initial imaging investigation in patients with head and neck cancer. Its high sensitivity and specificity (when combined with a guided FNAC) makes it a useful tool for cervical lymph node staging and investigating thyroid and salivary gland tumours. Grey-scale ultrasound evaluates the internal architecture and local extent of superficially located head and neck cancers, and colour Doppler examines the tumour vascularity. Advances in elastography and contrast ultrasound further enhance the diagnostic capability of ultrasound. In addition, following treatment of head and neck cancer, ultrasound is a useful and safe tool for disease surveillance and assessment of treatment response.

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References

  1. Wong KT, Ahuja AT. Ultrasound of thyroid cancer. Cancer Imaging. 2005;5:157–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Tunbridge WM, Evered DC, Hall R, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf). 1977;7:481–93.

    Article  CAS  Google Scholar 

  3. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med. 1968;69:537–40.

    Article  CAS  PubMed  Google Scholar 

  4. Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997;126:226–31.

    Article  CAS  PubMed  Google Scholar 

  5. Hegedüs L. Clinical practice. The thyroid nodule. N Engl J Med. 2004;351:1764–71.

    Article  PubMed  Google Scholar 

  6. Mandel SJ. A 64-year-old woman with a thyroid nodule. JAMA. 2004;292:2632–42.

    Article  CAS  PubMed  Google Scholar 

  7. Cooper DS, Doherty GM, Haugen BR, The American Thyroid Association Guidelines Taskforce, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16:109–42.

    Article  PubMed  Google Scholar 

  8. Papini E, Guglielmi R, Bianchini A, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87:1941–6.

    Article  CAS  PubMed  Google Scholar 

  9. Leenhardt L, Hejblum G, Franc B, et al. Indications and limits of ultrasound-guided cytology in the management of nonpalpable thyroid nodules. J Clin Endocrinol Metab. 1999;84:24–8.

    Article  CAS  PubMed  Google Scholar 

  10. Brkljacić B, Cuk V, Tomić-Brzac H, Bence-Zigman Z, Delić-Brkljacić D, Drinković I. Ultrasonic evaluation of benign and malignant nodules in echographically multinodular thyroids. J Clin Ultrasound. 1994;22:71–6.

    Article  PubMed  Google Scholar 

  11. Takashima S, Fukuda H, Nomura N, Kishimoto H, Kim T, Kobayashi T. Thyroid nodules: re-evaluation with ultrasound. J Clin Ultrasound. 1995;23:179–84.

    Article  CAS  PubMed  Google Scholar 

  12. Cerbone G, Spiezia S, Colao A, et al. Power Doppler improves the diagnostic accuracy of color Doppler ultrasonography in cold thyroid nodules: follow-up results. Horm Res. 1999;52:19–24.

    Article  CAS  PubMed  Google Scholar 

  13. Rago T, Vitti P, Chiovato L, et al. Role of conventional ultrasonography and color flow Doppler sonography in predicting malignancy in ‘cold’ thyroid nodules. Eur J Endocrinol. 1998;138:41–6.

    Article  CAS  PubMed  Google Scholar 

  14. Marqusee E, Benson CB, Frates MC, et al. Usefulness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med. 2000;133:696–700.

    Article  CAS  Google Scholar 

  15. Frates MC, Benson CB, Doubilet PM, et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006;91:3411–7.

    Article  CAS  PubMed  Google Scholar 

  16. Ahuja A, Chick W, King W, Metreweli C. Clinical significance of the comet-tail artifact in thyroid ultrasound. J Clin Ultrasound. 1996;24:129–33.

    Article  CAS  PubMed  Google Scholar 

  17. Yousem DM, Scheff AM. Thyroid and parathyroid. In: Som PM, Curtin HD, editors. Head and neck imaging. 3rd ed. St. Louis: Mosby; 1996. p. 953–75.

    Google Scholar 

  18. Wienke JR, Chong WK, Fielding JR, Zou KH, Mittelstaedt CA. Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. J Ultrasound Med. 2003;22:1027–31.

    PubMed  Google Scholar 

  19. Reading CC, Charboneau JW, Hay ID, Sebo TJ. Sonography of thyroid nodules: a “classic pattern” diagnostic approach. Ultrasound Q. 2005;21:157–65.

    Article  PubMed  Google Scholar 

  20. Taki S, Terahata S, Yamashita R, et al. Thyroid calcifications: sonographic patterns and incidence of cancer. Clin Imaging. 2004;28:368–71.

    Article  PubMed  Google Scholar 

  21. Berni A, Tromba L, Falvo L, Marchesi M, Grilli P, Peparini N. Malignant thyroid nodules: comparison between color Doppler diagnosis and histological examination of surgical samples. Chir Ital. 2002;54:643–7.

    PubMed  Google Scholar 

  22. Levine RA. Value of Doppler ultrasonography in management of patients with follicular thyroid biopsy specimens. Endocr Pract. 2006;12:270–4.

    Article  PubMed  Google Scholar 

  23. Lyshchik A, Higashi T, Asato R, et al. Thyroid gland tumor diagnosis at US elastography. Radiology. 2005;237:202–11.

    Article  PubMed  Google Scholar 

  24. Rago T, Santini F, Scutari M, Pinchera A, Vitti P. Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab. 2007;92:2917–22.

    Article  CAS  PubMed  Google Scholar 

  25. Azizi G, Keller J, Lewis Pa M, Puett DW, Rivenbark K, Malchoff CD. Performance of elastography for the evaluation of thyroid nodules: a prospective study. Thyroid. 2013;23(6):734–40.

    Article  PubMed  Google Scholar 

  26. Bhatia KSS, Lee YYP, Yuen EHY, Ahuja AT. Ultrasound elastography in the head and neck. Part II. Accuracy for malignancy. Cancer Imaging. 2013;13(2):260–76.

    Article  PubMed  PubMed Central  Google Scholar 

  27. McQuone SJ, Eisele DW. Cervical lymph node metastases in well-differentiated thyroid carcinoma. In: Proceedings of 4th international conference on head and neck cancer; 1996, p. 967–71.

    Google Scholar 

  28. Noguchi M, Yamada H, Ohta N, et al. Regional lymph node metastases in well-differentiated thyroid carcinoma. Int Surg. 1987;72:100–3.

    CAS  PubMed  Google Scholar 

  29. Mazzaferri EL, Young RL. Papillary thyroid carcinoma: a 10 year follow up report of the impact of therapy in 576 patients. Am J Med. 1981;70:511–8.

    Article  CAS  PubMed  Google Scholar 

  30. Carcangiu ML, Zampi G, Pupi A, Castagnoli A, Rosai J. Papillary carcinoma of the thyroid. A clinicopathologic study of 241 cases treated at the University of Florence, Italy. Cancer. 1985;55:805–28.

    Article  CAS  PubMed  Google Scholar 

  31. Harness JK, Thompson NW, McLeod MK, Eckhauser FE, Lloyd RV. Follicular carcinoma of the thyroid gland: trends and treatment. Surgery. 1984;96:972–80.

    CAS  PubMed  Google Scholar 

  32. LiVolsi VA. Pathology of thyroid disease. In: Falk SA, editor. Thyroid disease: endocrinology, surgery, nuclear medicine and radiotherapy. Philadelphia: Lippincott-Raven; 1997. p. 65–104.

    Google Scholar 

  33. Ahuja AT, Chow L, Chick W, King W, Metreweli C. Metastatic cervical nodes in papillary carcinoma of the thyroid: ultrasound and histological correlation. Clin Radiol. 1995;50:229–31.

    Article  CAS  PubMed  Google Scholar 

  34. King AD, Ahuja AT, To EW, Tse GM, Metreweli C. Staging papillary carcinoma of the thyroid: magnetic resonance imaging vs. ultrasound of the neck. Clin Radiol. 2000;55:222–6.

    Article  CAS  PubMed  Google Scholar 

  35. Ahuja AT, Evan RM, Valantis AC. Salivary gland cancer. In: Ahuja AT, Evans RM, King AD, et al., editors. Imaging in head and neck cancer. London: Greenwich Medical Media; 2003. p. 115–41.

    Google Scholar 

  36. Frable MA, Frable WJ. Fine-needle aspiration biopsy of salivary glands. Laryngoscope. 1991;101:245–9.

    Article  CAS  PubMed  Google Scholar 

  37. Cohen MB, Reznicek MJ, Miller TR. Fine-needle aspiration biopsy of the salivary glands. Pathol Annu. 1992;27:213–45.

    PubMed  Google Scholar 

  38. Jayaram G, Verma AK, Sood N, Khurana N. Fine needle aspiration cytology of salivary gland lesions. J Oral Pathol Med. 1994;23:256–61.

    Article  CAS  PubMed  Google Scholar 

  39. Snyderman NI, Suen JY. Neoplasms. In: Cummings CW, Fredrickson JM, Harker LA et al. Editos. Otolaryngology – head and neck surgery, Chapter 58, 2nd edn. Mosby Year Book, St. Louis; 1986, p. 1027–69.

    Google Scholar 

  40. Choi DS, Na DG, Byun HS, et al. Salivary gland tumors: evaluation with two-phase helical CT. Radiology. 2000;214:231–6.

    Article  CAS  PubMed  Google Scholar 

  41. Silvers AR, Som PM. Salivary glands. Radiol Clin North Am. 1998;36:941–66.

    Article  CAS  PubMed  Google Scholar 

  42. Bradley MJ, Durham LH, Lancer JM. The role of colour flow Doppler in the investigation of the salivary gland tumour. Clin Radiol. 2000;55:759–62.

    Article  CAS  PubMed  Google Scholar 

  43. Martinoli C, Derchi LE, Solbiati L, Rizzatto G, Silvestri E, Giannoni M. Color Doppler sonography of salivary glands. AJR Am J Roentgenol. 1994;163:933–41.

    Article  CAS  PubMed  Google Scholar 

  44. Som PM, Brandwein M. Salivary glands. In: Som PM, Curtin HD, editors. Head and neck imaging. 3rd ed. St. Louis: Mosby; 1996. p. 823–914.

    Google Scholar 

  45. Ishii J, Amagasa T, Tachibana T, Shinozuka K, Shioda S. US and CT evaluation of cervical lymph node metastasis from oral cancer. J Craniomaxillofac Surg. 1991;19:123–7.

    Article  CAS  PubMed  Google Scholar 

  46. Vassallo P, Edel G, Roos N, Naguib A, Peters PE. In-vitro high-resolution ultrasonography of benign and malignant lymph nodes. A sonographic-pathologic correlation. Invest Radiol. 1993;28:698–705.

    Article  CAS  PubMed  Google Scholar 

  47. Vassallo P, Wernecke K, Roos N, Peters PE. Differentiation of benign from malignant superficial lymphadenopathy: the role of high-resolution US. Radiology. 1992;183:215–20.

    Article  CAS  PubMed  Google Scholar 

  48. van den Brekel MW, Stel HV, Castelijns JA, et al. Cervical lymph node metastasis: assessment of radiologic criteria. Radiology. 1990;177:379–84.

    Article  PubMed  Google Scholar 

  49. Ahuja A, Ying M, King W, Metreweli C. A practical approach to ultrasound of cervical lymph nodes. J Laryngol Otol. 1997;111:245–56.

    Article  CAS  PubMed  Google Scholar 

  50. Ariji Y, Kimura Y, Hayashi N, et al. Power Doppler sonography of cervical lymph nodes in patients with head and neck cancer. AJNR Am J Neuroradiol. 1998;19:303–7.

    CAS  PubMed  Google Scholar 

  51. Wu CH, Hsu MM, Chang YL, Hsieh FJ. Vascular pathology of malignant cervical lymphadenopathy: qualitative and quantitative assessment with power Doppler ultrasound. Cancer. 1998;83:1189–96.

    Article  CAS  PubMed  Google Scholar 

  52. Steinkamp HJ, Mueffelmann M, Böck JC, Thiel T, Kenzel P, Felix R. Differential diagnosis of lymph node lesions: a semiquantitative approach with colour Doppler ultrasound. Br J Radiol. 1998;71:828–33.

    Article  CAS  PubMed  Google Scholar 

  53. Baatenburg de Jong RJ, Rongen RJ, Laméris JS, Harthoorn M, Verwoerd CD, Knegt P. Metastatic neck disease: Palpation vs. ultrasound examination. Arch Otolaryngol Head Neck Surg. 1989;115:689–90.

    Article  CAS  PubMed  Google Scholar 

  54. Ahuja A, Leung SF, Ying M, Metreweli C. Echography of metastatic nodes treated by radiotherapy. J Laryngol Otol. 1999;113:993–8.

    Article  CAS  PubMed  Google Scholar 

  55. Ahuja A, Ying M, Evans R, King W, Metreweli C. The application of ultrasound criteria for malignancy in differentiating tuberculous cervical adenitis from metastatic nasopharyngeal carcinoma. Clin Radiol. 1995;50:391–5.

    Article  CAS  PubMed  Google Scholar 

  56. Shozushima M, Suzuki M, Nakasima T, Yanagisawa Y, Sakamaki K, Takeda Y. Ultrasound diagnosis of lymph node metastasis in head and neck cancer. Dentomaxillofac Radiol. 1990;19:165–70.

    Article  CAS  PubMed  Google Scholar 

  57. Ying M, Ahuja A, Brook F, Metreweli C. Vascularity and grey-scale sonographic features of normal cervical lymph nodes: variations with nodal size. Clin Radiol. 2001;56:416–9.

    Article  CAS  PubMed  Google Scholar 

  58. Evans RM, Ahuja A, Metreweli C. The linear echogenic hilus in cervical lymphadenopathy—a sign of benignity or malignancy? Clin Radiol. 1993;47:262–4.

    Article  CAS  PubMed  Google Scholar 

  59. Som PM. Lymph nodes of the neck. Radiology. 1987;165:593–600.

    Article  CAS  PubMed  Google Scholar 

  60. Ishii J, Fujii E, Suzuki H, Shinozuka K, Kawase N, Amagasa T. Ultrasonic diagnosis of oral and neck malignant lymphoma. Bull Tokyo Med Dent Univ. 1992;39:63–9.

    CAS  PubMed  Google Scholar 

  61. Bruneton JN, Normand F, Balu-Maestro C, et al. Lymphomatous superficial lymph nodes: US detection. Radiology. 1987;165:233–5.

    Article  CAS  PubMed  Google Scholar 

  62. Ahuja AT, Ying M, Yuen HY, Metreweli C. ‘Pseudocystic’ appearance of non-Hodgkin’s lymphomatous nodes: an infrequent finding with high resolution transducers. Clin Radiol. 2001;56:111–5.

    Article  CAS  PubMed  Google Scholar 

  63. Swartz JD, Yussen PS, Popky GL. Imaging of the neck: nodal disease. Crit Rev Diagn Imaging. 1991;31:413–69.

    CAS  PubMed  Google Scholar 

  64. Ahuja A, Ying M, Leung SF, Metreweli C. The sonographic appearance and significance of cervical metastatic nodes following radiotherapy for nasopharyngeal carcinoma. Clin Radiol. 1996;51:698–701.

    Article  CAS  PubMed  Google Scholar 

  65. Ying M, Ahuja A, Brook F. Repeatability of power Doppler sonography of cervical lymph nodes. Ultrasound Med Biol. 2002;28:737–44.

    Article  PubMed  Google Scholar 

  66. Na DG, Lim HK, Byun HS, Kim HD, Ko YH, Baek JH. Differential diagnosis of cervical lymphadenopathy: usefulness of color Doppler sonography. AJR Am J Roentgenol. 1997;168:1311–6.

    Article  CAS  PubMed  Google Scholar 

  67. Ying M, Ahuja A, Brook F, Metreweli C. Power Doppler sonography of normal cervical lymph nodes. J Ultrasound Med. 2000;19:511–7.

    CAS  PubMed  Google Scholar 

  68. Steinkamp HJ, Mäurer J, Cornehl M, Knöbber D, Hettwer H, Felix R. Recurrent cervical lymphadenopathy: differential diagnosis with color-duplex sonography. Eur Arch Otorhinolaryngol. 1994;251:404–9.

    Article  CAS  PubMed  Google Scholar 

  69. Ahuja AT, Ying M, Ho SS, Metreweli C. Distribution of intranodal vessels in differentiating benign from metastatic neck nodes. Clin Radiol. 2001;56:197–201.

    Article  CAS  PubMed  Google Scholar 

  70. van den Brekel MW, Stel HV, Castelijns JA, Croll GJ, Snow GB. Lymph node staging in patients with clinically negative neck examinations by ultrasound and ultrasound-guided aspiration cytology. Am J Surg. 1991;162:362–6.

    Article  PubMed  Google Scholar 

  71. van den Brekel MW, Castelijns JA, Stel HV, et al. Occult metastatic neck disease: detection with US and US-guided fine-needle aspiration cytology. Radiology. 1991;180:457–61.

    Article  PubMed  Google Scholar 

  72. Moritz JD, Ludwig A, Oestmann JW. Contrast-enhanced color Doppler sonography for evaluation of enlarged cervical lymph nodes in head and neck tumors. AJR Am J Roentgenol. 2000;174:1279–84.

    Article  CAS  PubMed  Google Scholar 

  73. Rubaltelli L, Khadivi Y, Tregnaghi A, et al. Evaluation of lymph node perfusion using continuous mode harmonic ultrasonography with a second-generation contrast agent. J Ultrasound Med. 2004;23:829–36.

    PubMed  Google Scholar 

  74. Lee YY, Antonio GE, Ho SSY, et al. Serial dynamic sonographic contrast enhancement changes in cervical lymph nodes: before and after treatment for lymphoma. In: International and 9th national head and neck cancer conference, 7–11 Sept 2007, Urumqi.

    Google Scholar 

  75. Ahuja AT, Ying M, Ho SY, et al. Ultrasound of malignant cervical lymph nodes. Cancer Imaging. 2008;8:48–56.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Ho SS, Ahuja AT, Yeo W, Chan TC, Kew J, Metreweli C. Longitudinal colour Doppler study of superficial lymph nodes in non-Hodgkin’s lymphoma patients on chemotherapy. Clin Radiol. 2000;55:110–3.

    Article  CAS  PubMed  Google Scholar 

  77. Lee YYP, Wong KT, King AD, Ahuja AT. Imaging of salivary gland tumours. Eur J Radiol. 2008;66:419–36.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Imaging and Interventional Radiology, Prince of Wales Hospital, 230-32 Ngan Shing Street, Shatin, Hong Kong SAR, China

    Yolanda Y. P. Lee FRCR, MBChB

  2. Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China

    Ka Tak Wong MBChB, FRCR, Kunwar Suryaveer Singh Bhatia BMedSci, BMBS, MRCS, DLO, FRCR & Anil Tejbhan Ahuja MD, FRCR, FHKCR, FHKAM (Rad)

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  1. Yolanda Y. P. Lee FRCR, MBChB
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  2. Ka Tak Wong MBChB, FRCR
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  3. Kunwar Suryaveer Singh Bhatia BMedSci, BMBS, MRCS, DLO, FRCR
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  4. Anil Tejbhan Ahuja MD, FRCR, FHKCR, FHKAM (Rad)
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Correspondence to Yolanda Y. P. Lee FRCR, MBChB .

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  1. Department of Radio-Oncology, Genolier Swiss Medical Network, Genolier, Switzerland

    Jacques Bernier

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Lee, Y.Y.P., Wong, K.T., Bhatia, K.S.S., Ahuja, A.T. (2016). Ultrasound Investigations in Head and Neck Cancer Patients. In: Bernier, J. (eds) Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-27601-4_14

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