Novel Diagnostic Approaches for Assessment of the Clinically Negative Neck in Head and Neck Cancer Patients

Daphne A J J Driessen; Tim Dijkema; Willem L J Weijs; Robert P Takes; Sjoert A H Pegge; Patrik Zámecnik; Adriana C H van Engen-van Grunsven; Tom W J Scheenen; Johannes H A M Kaanders

doi:10.3389/fonc.2020.637513

Novel Diagnostic Approaches for Assessment of the Clinically Negative Neck in Head and Neck Cancer Patients

Front Oncol. 2021 Feb 5:10:637513. doi: 10.3389/fonc.2020.637513. eCollection 2020.

Authors

Daphne A J J Driessen¹, Tim Dijkema¹, Willem L J Weijs², Robert P Takes³, Sjoert A H Pegge⁴, Patrik Zámecnik⁴, Adriana C H van Engen-van Grunsven⁵, Tom W J Scheenen⁴, Johannes H A M Kaanders¹

Affiliations

¹ Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, Netherlands.
² Department of Oral- and Maxillofacial Surgery and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, Netherlands.
³ Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, Netherlands.
⁴ Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands.
⁵ Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands.

Abstract

In head and neck cancer, the presence of nodal disease is a strong determinant of prognosis and treatment. Despite the use of modern multimodality diagnostic imaging, the prevalence of occult nodal metastases is relatively high. This is why in clinically node negative head and neck cancer the lymphatics are treated "electively" to eradicate subclinical tumor deposits. As a consequence, many true node negative patients undergo surgery or irradiation of the neck and suffer from the associated and unnecessary early and long-term morbidity. Safely tailoring head and neck cancer treatment to individual patients requires a more accurate pre-treatment assessment of nodal status. In this review, we discuss the potential of several innovative diagnostic approaches to guide customized management of the clinically negative neck in head and neck cancer patients.

Keywords: FDG-PET/CT; elective neck treatment; head and neck cancer; lymph node metastases; nanoparticles enhanced MRI; nodal staging; sentinel lymph node identification.

Publication types

Review