Table 6.
Summary table of studies evaluating CT detection of ECS in patients with HNSCC.
| Author | CT criteria | Sample size (ECS+) | Sn/Spa | PPV/NPV | Agreement (kappa) | Conclusion for preop CT detectability of ECS |
|---|---|---|---|---|---|---|
| King16 | IM, AI, IE | 51 (37) | CT MR 65/93 78/86 | –/– | 0.6, 0.5 | Comparable with MRI |
| Souter15 | IM, IE, PFC, thick-wall | 113 (N/A) | 66, 80/91, 90 | 85, 87/–,– | 0.67 | Radiologist experience improves accuracy |
| Url14 | AI | 49 (17) | 71, 76/91, 91 | –/– | 0.86 | High Sp |
| Chai18 | IM, AI, CI | 100 (63) | 49, 65/84, 54 | 84, 71/49, 48 | 0.37 | Not reliable |
| Prabhu17 | AI, IB, PFC | 432 (87) | 44/98 | 83/87 | – | High Sp; detectability rises with ECS grade |
| Randall20 | IM, CI, IE, CN | 40 (17) | For CN 91/50 | CN 59/88 | 0.49 CN 0.71 | CN on CT correlates with ECS in oral SCC |
| Aiken21 | AI, IB, PFC | 111 (29) | 68/88 for CN 66/93 | 66/89 | 0.86 | High Sp in oral HNSCC. CN is best criterion |
| Maxwell19 | IM, AI, PFC, CI | 65 (38) | 55, 47/70, 85 | 72, 82/53, 53 | 0.37 | Not reliable in p16+ |
| Carlton | IM, AI, IE, CN, matted | 93 (56) | 57,66/81,76 3+ criteria: 41, 54/89, 86 | 82,80/56,60 3+ criteria: 85, 86/50, 55 | 0.59 | Moderate Sp; 3+ criteria improves Sp |
CT: computed tomography; MRI: magnetic resonance imaging; ECS: extracapsular spread; HNSCC: squamous cell carcinoma of the head and neck; HP: histopathological; SCC: squamous cell carcinoma; IM: indistinct margins; AI: adjacent invasion; IB: irregular borders; CI: contour irregularity; IE: irregular/marginal enhancement; PFC: perinodal fat changes; CN: central necrosis; Sn: sensitivity; Sp: specificity.
a
In studies that reported results for individual reviewers, the results are included as results for observer 1, results for observer 2.