Examination about US diagnosis of cervical lymph node after chemoradiotherapy

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K11254
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Otorhinolaryngology
• Research Institution: Aichi Cancer Center Research Institute
• Principal Investigator: HANAI Nobuhiro 愛知県がんセンター(研究所), がん予防研究分野, 研究員 (80381797)
• Research Collaborator: FURUKAWA Madoka ; MATSUURA Kazuto ; FUJIMOTO Yasushi ; MONDEN Nobuya ; SHIMODE Yuzo
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 超音波検査 / 頭頸部癌 / 化学放射線療法 / 頸部リンパ節転移

Outline of Final Research Achievements

Cervical lymph node diagnosis was performed using the treatment effect criteria (draft) after CRT by US, and the usefulness of US diagnosis after CRT was evaluated. As a final result, the correct diagnosis rate of US was 81% (specificity 83%, negative predictive value 86%). There were significant changes in size, echo level and blood flow in the observation items before and 12 weeks after treatment. On the other hand, the correct diagnosis rate of PET-CT was 94% (specificity 93%, negative predictive value 100%). Although the correct diagnosis rate was less than that of PET-CT, there is a possibility that the accuracy can be further improved by the improvement of the treatment effect judgment criteria (draft) and the equalization of the interpretation among the practitioners. The US was shown to be excellent in that it was inexpensive and simple, and was minimally invasive and repeatable.

Free Research Field

頭頸部外科学

Academic Significance and Societal Importance of the Research Achievements

CRT後の頸部リンパ節診断は正診率においてPET-CTが最も優れると言われるが、PET-CTは設備の偏在、また高額であることから保険制度上の施行制限があり、実臨床ではCTによって診断を行わざるを得ない場面も多い。本研究はCRT後の頸部リンパ節診断におけるUS診断の有用性、またCTに対する優位性を示したものである。USは人体にとって低侵襲であり、反復検査を行うことが出来る。US診断を用いることによって、患者負担を軽減し、医療経済面でもコストの軽減が可能である。