Diagnostic Performance of Adaptive 4D Volume Perfusion CT for Detecting Metastatic Cervical Lymph Nodes in Head and Neck Squamous Cell Carcinoma

OBJECTIVE. The purpose of this study was to investigate the diagnostic performance of adaptive 4D volume perfusion CT covering the entire neck for detecting metastatic nodes in patients with head and neck squamous cell carcinoma. SUBJECTS AND METHODS. Thirty patients with histologically confirmed disease were enrolled. The relation between perfusion parameters and nodal size was analyzed, and perfusion parameters were compared between metastatic and benign nodes. The diagnostic capability for detecting metastatic nodes was evaluated. RESULTS. Significant inverse correlations with nodal size were found for blood flow (r = −0.40, p = 0.002), blood volume (r = −0.32, p = 0.02), and permeability surface product (r = −0.27, p = 0.04) of the metastatic nodes. All three parameters had significantly higher values in association with nodal maximum diameter < 10 mm compared with diameter ≥ 10 mm (blood flow, p = 0.004; blood volume, p = 0.01; permeability surface product, p = 0.02). Among the nodes with maximum dia...