An imaging-based classification for the cervical nodes designed as an adjunct to recent clinically based nodal classifications.

Over the past 18 years, numerous classifications have been proposed to distinguish among the diverse nodal levels. Some classifications have used surgical landmarks, others physical assessment criteria. These classifications do not agree precisely and exhibit sufficient variation that competent physicians could arrive at slightly different staging of the patient's nodal disease. In the past 2 decades, computed tomography and magnetic resonance imaging have offered progressively more refined anatomical precision, reproducibility, and visualization of deep, clinically inaccessible structures. Because the majority of patients with head and neck malignancies presently undergo sectional imaging prior to treatment planning, we felt a need to integrate anatomical imaging criteria with the 2 most commonly used nodal classifications: those of the American Joint Committee on Cancer and those of the American Academy of Otolaryngology-Head and Neck Surgery. The imaging-based nodal classification proposed herein has been developed in consultation with surgeons interested in such classifications in the hope that the resultant classification would find ready acceptance by both clinicians and imagers. It is our desire that the best attributes of imaging, combined with those of the physical assessment, can result in a better and more consistently reproducible nodal staging than is possible by either

[1]  E. Weymuller Clinical staging and operative reporting for multi‐institutional trials in head and neck squamous cell carcinoma , 1997, Head & neck.

[2]  W. Hanafee,et al.  CT of cervical lymph node cancer. , 1981, AJR. American journal of roentgenology.

[3]  J. Krmpotiĉ [Lymphatic system of the head and neck]. , 1965, Chirurgia maxillofacialis & plastica.

[4]  D. Reede,et al.  Metastatic hypernephroma to the head and neck. , 1987, AJNR. American journal of neuroradiology.

[5]  H. Harnsberger,et al.  Computed tomography of cervical and retropharyngeal lymph nodes: normal anatomy, variants of normal, and applications in staging head and neck cancer. Part II: pathology. , 1983, Radiology.

[6]  K. Robbins,et al.  Classification of neck dissection: current concepts and future considerations. , 1998, Otolaryngologic clinics of North America.

[7]  R. Spiro The management of neck nodes in head and neck cancer: a surgeon's view. , 1985, Bulletin of the New York Academy of Medicine.

[8]  H. Goepfert,et al.  Standardization of neck dissection nomenclature. , 1987, Head & neck surgery.

[9]  L. Testut,et al.  Traité d'anatomie humaine , 1905 .

[10]  H. Harnsberger,et al.  Computed tomography of cervical and retropharyngeal lymph nodes: normal anatomy, variants of normal, and applications in staging head and neck cancer. Part I: normal anatomy. , 1983, Radiology.

[11]  G. Snow,et al.  Assessment of lymph node metastases in the neck. , 1994, European journal of cancer. Part B, Oral oncology.

[12]  J. Medina A Rational Classification of Neck Dissections , 1989, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[13]  P. Som,et al.  Lymph nodes of the neck. , 1987, Radiology.

[14]  B Vikram,et al.  Surgical grand rounds. Neck dissection: current status and future possibilities. , 1981, Clinical bulletin.

[15]  B J McNeil,et al.  Comparison of CT and MR Imaging in Staging of Neck , 2005 .

[16]  R. Lindberg Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts , 1972, Cancer.

[17]  P. Poirier,et al.  Traité d'anatomie humaine , 1899 .

[18]  H. Goepfert,et al.  Editorial. Standardization of neck dissection nomenclature , 1987 .

[19]  C. E. Sedgwick,et al.  Surgical Anatomy , 1849, Major problems in clinical surgery.