American Journal of Roentgenology, Vol 173, 1505-1508, Copyright © 1999 by American Roentgen Ray Society

ARTICLES

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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