Evidence map›Paper›PMID 39580776›Full record

ArticleLa Radiologia medica2025

Nodal assessment and extranodal extension in head and neck squamous cell cancer: insights from computed tomography and magnetic resonance imaging.

Nicola Maggialetti, Ilaria Villanova, Sara Greco, Angela Sardaro, Maria Teresa Lagrasta, Claudia Dipalma, Fabio Maglitto, Eleonora Bicci, Nicola Maria Lucarelli, Chiara Copelli and 1 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in La Radiologia medica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Nicola MaggialettiInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.
Ilaria VillanovaInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.
Sara GrecoInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy. saragrecosa@gmail.com.
Angela SardaroInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.
Maria Teresa LagrastaInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.
Claudia DipalmaInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.
Fabio MaglittoInterdisciplinary Department of Medicine, Facial Surgery, Operative Unit of Maxillo, UniversityofBari"Aldo Moro", University-Hospital "Policlinico Consorziale Di Bari", Bari, Italy.
Eleonora BicciDepartment of Radiology, Head and Neck Unit, Careggi University Hospital, Florence, Italy.
Nicola Maria LucarelliInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.
Chiara CopelliInterdisciplinary Department of Medicine, Facial Surgery, Operative Unit of Maxillo, UniversityofBari"Aldo Moro", University-Hospital "Policlinico Consorziale Di Bari", Bari, Italy.
Amato Antonio Stabile IanoraInterdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of the study was to evaluate the concordance between computed tomography (CT)/magnetic resonance imaging (MRI) and histological examination in the evaluation of lymph nodal involvement (N+) and extranodal extension (ENE+) in patients with squamous cell cancer of the head-neck district (HNSCC). The second end point was to evaluate which of the imaging features was more sensitive and specific in establishing N+ and ENE+, and comparing the diagnostic accuracy between CT and MRI. MATERIAL AND

methods58 patients with HNSCC undergoing surgical treatment with lymph node dissection at the Policlinico of Bari were enrolled in this retrospective study. The criteria used for identifying radiological N+ (rN+) included six characteristics; the presence of any two or more criteria out of these six was considered rN+. For each rN+, the radiological extranodal extension (rENE+) was evaluated analyzing three characteristics; rENE was considered positive if any one criterion was present.

resultsOf 167 lymph nodes, 45/167 (27%) had rN+, out of which 20/45 (44%) were rENE+. On pathological examination, 38/45 (84%) nodes were N+ and 11/20 (55%) were ENE+. The agreement between imaging and histology in the evaluation of N was (149/167) 89% with a good concordance (k = 0.7). The agreement between imaging and histology in the evaluation of ENE was (35/45) 78% with a moderate concordance (k = 0.5). Loss of fatty hilum was found to be the most sensitive (84%) imaging finding in N+ evaluation. Capsular irregularity with fat stranding had the highest sensitivity (82%) for the determination of ENE+. Comparing CT and MRI imaging in the evaluation of N+ and ENE+, we found no statistically significant differences (p-value of 0.3 for N+ and p-value of 0.3 for ENE +).

conclusionsImaging has good confidence in detecting rN+ but modest in assessing rENE+. Further research could improve the imaging specificity for the determination of rENE.

Indexed as

Carcinoma, Squamous CellExtranodal ExtensionHead and Neck NeoplasmsLymphatic MetastasisMagnetic Resonance ImagingTomography, X-Ray ComputedAdultAgedAged, 80 and overContrast MediaFemaleHumansLymph NodesMaleMiddle AgedRetrospective StudiesContrast MediaComputed tomographyExtranodal extensionHead and neckLymph nodesMagnetic resonance imagingSquamous cell cancer

Identifiers

PMID39580776

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.