Accuracy of computed tomography to predict extracapsular spread in p16-positive squamous cell carcinoma

Jessica H. Maxwell, Tanya J. Rath, James K. Byrd, William G. Albergotti, Hong Wang, Umamaheswar Duvvuri, Seungwon Kim, Jonas T. Johnson, Barton F. Branstetter, Robert L. Ferris

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective To determine the accuracy of pretreatment, contrast-enhanced computed tomography (CT) in the diagnosis of extracapsular spread (ECS) in cervical lymph node metastases from p16-positive head-and-neck squamous cell carcinoma (HNSCC). Study Design Retrospective observational study. Methods Sixty-five (n = 65) patients diagnosed between 2004 and 2013 with p16-positive HNSCC and with cervical lymph node metastases measuring at least 1 centimeter in diameter on pathological assessment were included. All patients underwent primary surgical treatment. Subjects' preoperative contrast-enhanced neck CT scans were independently assigned a score for the likelihood of ECS (5-point scale) by two board-certified neuroradiologists. Receiver-operating characteristic curves were generated, and optimal sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for each radiologist. Results On histological analysis, the majority of patients (58%; 38/65) were found to have ECS, and 29% (19/65) of patients had ≥ three metastatic lymph nodes. For radiologist 1, PPV and NPV for ECS detection were 72% (95% confidence interval (CI), 53%-87%) and 53% (95% CI, 36%-70%), respectively. For radiologist 2, PPV and NPV for ECS detection were 82% (95% CI, 60 %-95%) and 53% (95% CI, 38%-69%), respectively. Conclusion CT is not a reliable method for determining the presence of ECS in p16-positive HNSCC patients.

Original languageEnglish (US)
Pages (from-to)1613-1618
Number of pages6
JournalLaryngoscope
Volume125
Issue number7
DOIs
StatePublished - Jul 1 2015
Externally publishedYes

Fingerprint

Squamous Cell Carcinoma
Tomography
Confidence Intervals
Lymph Nodes
Neoplasm Metastasis
ROC Curve
Observational Studies
Neck
Retrospective Studies
Sensitivity and Specificity
Radiologists
Carcinoma, squamous cell of head and neck
Therapeutics

Keywords

  • Extracapsular spread
  • HPV
  • computed tomography
  • p16

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Maxwell, J. H., Rath, T. J., Byrd, J. K., Albergotti, W. G., Wang, H., Duvvuri, U., ... Ferris, R. L. (2015). Accuracy of computed tomography to predict extracapsular spread in p16-positive squamous cell carcinoma. Laryngoscope, 125(7), 1613-1618. https://doi.org/10.1002/lary.25140

Accuracy of computed tomography to predict extracapsular spread in p16-positive squamous cell carcinoma. / Maxwell, Jessica H.; Rath, Tanya J.; Byrd, James K.; Albergotti, William G.; Wang, Hong; Duvvuri, Umamaheswar; Kim, Seungwon; Johnson, Jonas T.; Branstetter, Barton F.; Ferris, Robert L.

In: Laryngoscope, Vol. 125, No. 7, 01.07.2015, p. 1613-1618.

Research output: Contribution to journalArticle

Maxwell, JH, Rath, TJ, Byrd, JK, Albergotti, WG, Wang, H, Duvvuri, U, Kim, S, Johnson, JT, Branstetter, BF & Ferris, RL 2015, 'Accuracy of computed tomography to predict extracapsular spread in p16-positive squamous cell carcinoma', Laryngoscope, vol. 125, no. 7, pp. 1613-1618. https://doi.org/10.1002/lary.25140
Maxwell, Jessica H. ; Rath, Tanya J. ; Byrd, James K. ; Albergotti, William G. ; Wang, Hong ; Duvvuri, Umamaheswar ; Kim, Seungwon ; Johnson, Jonas T. ; Branstetter, Barton F. ; Ferris, Robert L. / Accuracy of computed tomography to predict extracapsular spread in p16-positive squamous cell carcinoma. In: Laryngoscope. 2015 ; Vol. 125, No. 7. pp. 1613-1618.
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title = "Accuracy of computed tomography to predict extracapsular spread in p16-positive squamous cell carcinoma",
abstract = "Objective To determine the accuracy of pretreatment, contrast-enhanced computed tomography (CT) in the diagnosis of extracapsular spread (ECS) in cervical lymph node metastases from p16-positive head-and-neck squamous cell carcinoma (HNSCC). Study Design Retrospective observational study. Methods Sixty-five (n = 65) patients diagnosed between 2004 and 2013 with p16-positive HNSCC and with cervical lymph node metastases measuring at least 1 centimeter in diameter on pathological assessment were included. All patients underwent primary surgical treatment. Subjects' preoperative contrast-enhanced neck CT scans were independently assigned a score for the likelihood of ECS (5-point scale) by two board-certified neuroradiologists. Receiver-operating characteristic curves were generated, and optimal sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for each radiologist. Results On histological analysis, the majority of patients (58{\%}; 38/65) were found to have ECS, and 29{\%} (19/65) of patients had ≥ three metastatic lymph nodes. For radiologist 1, PPV and NPV for ECS detection were 72{\%} (95{\%} confidence interval (CI), 53{\%}-87{\%}) and 53{\%} (95{\%} CI, 36{\%}-70{\%}), respectively. For radiologist 2, PPV and NPV for ECS detection were 82{\%} (95{\%} CI, 60 {\%}-95{\%}) and 53{\%} (95{\%} CI, 38{\%}-69{\%}), respectively. Conclusion CT is not a reliable method for determining the presence of ECS in p16-positive HNSCC patients.",
keywords = "Extracapsular spread, HPV, computed tomography, p16",
author = "Maxwell, {Jessica H.} and Rath, {Tanya J.} and Byrd, {James K.} and Albergotti, {William G.} and Hong Wang and Umamaheswar Duvvuri and Seungwon Kim and Johnson, {Jonas T.} and Branstetter, {Barton F.} and Ferris, {Robert L.}",
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AU - Maxwell, Jessica H.

AU - Rath, Tanya J.

AU - Byrd, James K.

AU - Albergotti, William G.

AU - Wang, Hong

AU - Duvvuri, Umamaheswar

AU - Kim, Seungwon

AU - Johnson, Jonas T.

AU - Branstetter, Barton F.

AU - Ferris, Robert L.

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Objective To determine the accuracy of pretreatment, contrast-enhanced computed tomography (CT) in the diagnosis of extracapsular spread (ECS) in cervical lymph node metastases from p16-positive head-and-neck squamous cell carcinoma (HNSCC). Study Design Retrospective observational study. Methods Sixty-five (n = 65) patients diagnosed between 2004 and 2013 with p16-positive HNSCC and with cervical lymph node metastases measuring at least 1 centimeter in diameter on pathological assessment were included. All patients underwent primary surgical treatment. Subjects' preoperative contrast-enhanced neck CT scans were independently assigned a score for the likelihood of ECS (5-point scale) by two board-certified neuroradiologists. Receiver-operating characteristic curves were generated, and optimal sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for each radiologist. Results On histological analysis, the majority of patients (58%; 38/65) were found to have ECS, and 29% (19/65) of patients had ≥ three metastatic lymph nodes. For radiologist 1, PPV and NPV for ECS detection were 72% (95% confidence interval (CI), 53%-87%) and 53% (95% CI, 36%-70%), respectively. For radiologist 2, PPV and NPV for ECS detection were 82% (95% CI, 60 %-95%) and 53% (95% CI, 38%-69%), respectively. Conclusion CT is not a reliable method for determining the presence of ECS in p16-positive HNSCC patients.

AB - Objective To determine the accuracy of pretreatment, contrast-enhanced computed tomography (CT) in the diagnosis of extracapsular spread (ECS) in cervical lymph node metastases from p16-positive head-and-neck squamous cell carcinoma (HNSCC). Study Design Retrospective observational study. Methods Sixty-five (n = 65) patients diagnosed between 2004 and 2013 with p16-positive HNSCC and with cervical lymph node metastases measuring at least 1 centimeter in diameter on pathological assessment were included. All patients underwent primary surgical treatment. Subjects' preoperative contrast-enhanced neck CT scans were independently assigned a score for the likelihood of ECS (5-point scale) by two board-certified neuroradiologists. Receiver-operating characteristic curves were generated, and optimal sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for each radiologist. Results On histological analysis, the majority of patients (58%; 38/65) were found to have ECS, and 29% (19/65) of patients had ≥ three metastatic lymph nodes. For radiologist 1, PPV and NPV for ECS detection were 72% (95% confidence interval (CI), 53%-87%) and 53% (95% CI, 36%-70%), respectively. For radiologist 2, PPV and NPV for ECS detection were 82% (95% CI, 60 %-95%) and 53% (95% CI, 38%-69%), respectively. Conclusion CT is not a reliable method for determining the presence of ECS in p16-positive HNSCC patients.

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