Diagnostic Performance of Magnetic Resonance Sequences in Staging Lymph Node Involvement and Extranodal Extension in Head and Neck Squamous Cell Carcinoma

<b>Objectives:</b> This study aimed to evaluate the diagnostic performance of various MRI sequences in detecting nodal metastasis (N+) and extranodal extension (ENE+) in patients with head and neck squamous cell carcinoma (HNSCC). <b>Methods</b>: A retrospective analysis was...

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Main Authors: Giovanni Lorusso, Nicola Maggialetti, Francesca Laugello, Annalisa Garofalo, Ilaria Villanova, Sara Greco, Chiara Morelli, Pasquale Pignataro, Nicola Maria Lucarelli, Amato Antonio Stabile Ianora
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/10/1251
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author Giovanni Lorusso
Nicola Maggialetti
Francesca Laugello
Annalisa Garofalo
Ilaria Villanova
Sara Greco
Chiara Morelli
Pasquale Pignataro
Nicola Maria Lucarelli
Amato Antonio Stabile Ianora
author_facet Giovanni Lorusso
Nicola Maggialetti
Francesca Laugello
Annalisa Garofalo
Ilaria Villanova
Sara Greco
Chiara Morelli
Pasquale Pignataro
Nicola Maria Lucarelli
Amato Antonio Stabile Ianora
author_sort Giovanni Lorusso
collection DOAJ
description <b>Objectives:</b> This study aimed to evaluate the diagnostic performance of various MRI sequences in detecting nodal metastasis (N+) and extranodal extension (ENE+) in patients with head and neck squamous cell carcinoma (HNSCC). <b>Methods</b>: A retrospective analysis was conducted on 42 patients with HNSCC who underwent preoperative MRI and subsequent surgical lymph node dissection between June 2021 and December 2023. Lymph node MRI features were evaluated on five different MRI sequences. For each rN+ case, the presence of radiological extranodal extension (rENE+) was assessed independently in every MRI sequence by analyzing three characteristics. ENE was deemed positive if at least one of three criteria considered was present. <b>Results</b>: All of the MRI sequences demonstrated slightly high accuracy (~76%) for detecting N+, with T1WI, STIR, and CE THRIVE showing comparable sensitivities (60–65%). The STIR sequence exhibited the highest sensitivity (75%) and nearly the highest accuracy (91%) for detecting ENE+. Capsular irregularity and necrosis showed high specificity across sequences, while the loss of fatty hilum and nodal size had lower performance. <b>Conclusions</b>: Tailoring MRI protocols to leverage the strengths of specific sequences can significantly improve the diagnostic accuracy, aiding in better patient management and treatment outcomes.
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spelling doaj-art-e8dd225742114d7fbba6a5622b2c89142025-08-20T03:14:31ZengMDPI AGDiagnostics2075-44182025-05-011510125110.3390/diagnostics15101251Diagnostic Performance of Magnetic Resonance Sequences in Staging Lymph Node Involvement and Extranodal Extension in Head and Neck Squamous Cell CarcinomaGiovanni Lorusso0Nicola Maggialetti1Francesca Laugello2Annalisa Garofalo3Ilaria Villanova4Sara Greco5Chiara Morelli6Pasquale Pignataro7Nicola Maria Lucarelli8Amato Antonio Stabile Ianora9Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy<b>Objectives:</b> This study aimed to evaluate the diagnostic performance of various MRI sequences in detecting nodal metastasis (N+) and extranodal extension (ENE+) in patients with head and neck squamous cell carcinoma (HNSCC). <b>Methods</b>: A retrospective analysis was conducted on 42 patients with HNSCC who underwent preoperative MRI and subsequent surgical lymph node dissection between June 2021 and December 2023. Lymph node MRI features were evaluated on five different MRI sequences. For each rN+ case, the presence of radiological extranodal extension (rENE+) was assessed independently in every MRI sequence by analyzing three characteristics. ENE was deemed positive if at least one of three criteria considered was present. <b>Results</b>: All of the MRI sequences demonstrated slightly high accuracy (~76%) for detecting N+, with T1WI, STIR, and CE THRIVE showing comparable sensitivities (60–65%). The STIR sequence exhibited the highest sensitivity (75%) and nearly the highest accuracy (91%) for detecting ENE+. Capsular irregularity and necrosis showed high specificity across sequences, while the loss of fatty hilum and nodal size had lower performance. <b>Conclusions</b>: Tailoring MRI protocols to leverage the strengths of specific sequences can significantly improve the diagnostic accuracy, aiding in better patient management and treatment outcomes.https://www.mdpi.com/2075-4418/15/10/1251HNSCCextranodal extensionlymph nodesmagnetic resonance imagingmagnetic resonance sequences
spellingShingle Giovanni Lorusso
Nicola Maggialetti
Francesca Laugello
Annalisa Garofalo
Ilaria Villanova
Sara Greco
Chiara Morelli
Pasquale Pignataro
Nicola Maria Lucarelli
Amato Antonio Stabile Ianora
Diagnostic Performance of Magnetic Resonance Sequences in Staging Lymph Node Involvement and Extranodal Extension in Head and Neck Squamous Cell Carcinoma
Diagnostics
HNSCC
extranodal extension
lymph nodes
magnetic resonance imaging
magnetic resonance sequences
title Diagnostic Performance of Magnetic Resonance Sequences in Staging Lymph Node Involvement and Extranodal Extension in Head and Neck Squamous Cell Carcinoma
title_full Diagnostic Performance of Magnetic Resonance Sequences in Staging Lymph Node Involvement and Extranodal Extension in Head and Neck Squamous Cell Carcinoma
title_fullStr Diagnostic Performance of Magnetic Resonance Sequences in Staging Lymph Node Involvement and Extranodal Extension in Head and Neck Squamous Cell Carcinoma
title_full_unstemmed Diagnostic Performance of Magnetic Resonance Sequences in Staging Lymph Node Involvement and Extranodal Extension in Head and Neck Squamous Cell Carcinoma
title_short Diagnostic Performance of Magnetic Resonance Sequences in Staging Lymph Node Involvement and Extranodal Extension in Head and Neck Squamous Cell Carcinoma
title_sort diagnostic performance of magnetic resonance sequences in staging lymph node involvement and extranodal extension in head and neck squamous cell carcinoma
topic HNSCC
extranodal extension
lymph nodes
magnetic resonance imaging
magnetic resonance sequences
url https://www.mdpi.com/2075-4418/15/10/1251
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