American Journal of Roentgenology, Vol 173, 1505-1508, Copyright © 1999 by American Roentgen Ray Society
Surveillance CT and the prompt use of CT-guided fine-needle aspiration in patients with head and neck cancer who have undergone surgery
PM Som, AR Silvers and ML Urken
Department of Radiology, the Mount Sinai School of Medicine, City University of New York, NY 10029, USA.
OBJECTIVE: The purpose of this study was to assess the usefulness of prompt
CT-guided fine-needle aspiration in the evaluation of suspected tumor
recurrence seen on surveillance images of patients who had undergone
surgery for head and neck cancer. SUBJECTS AND METHODS: We reviewed 32
patients who had undergone CT-guided fine-needle aspiration after surgery
for head and neck cancer. CT-guided fine-needle aspiration was performed
with a 22-gauge spinal needle and a cytopathologist was present to assess
the adequacy of the biopsy sample. As many as five needle passes were made.
RESULTS: Of the 32 cases, pathologic findings revealed squamous cell
carcinoma (n = 27), mucoepidermoid carcinoma (n = 2), neuroendocrine
carcinoma (n = 1), papillary thyroid carcinoma (n = 1), and adenocarcinoma
(n = 1). In 20 cases (62.5%) the results of CT-guided fine-needle
aspiration were positive for tumor recurrence, whereas in 11 cases (34.4%)
the results were negative. In one case (3.1%) the results were
nondiagnostic. Of the 11 patients with negative findings on CT-guided
fine-needle aspiration, two patients had a subsequent recurrence that was
not at the biopsy site. There were no complications from the procedure.
CONCLUSION: When a radiologist who is trained in head and neck imaging
identifies with CT a possible early recurrence of tumor, the prompt use of
CT-guided fine-needle aspiration is an effective way to diagnose these
tumors so that appropriate treatment can be initiated.
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