Abstract：
BACKGROUND: Occult nodal disease (OND) during clinically-N0 salvage total laryngectomy (TL) can be detected with the Neck-Imaging-Reporting-and-Data-Systems (NI-RADS). However, some patients will still have OND revealed on final pathology.
METHODS: A retrospective study on all patients who had OND during salvage TL with elective neck dissection (END) between 2009 and 2021 was performed. Repeat CT and PET scan interpretation was performed to evaluate their preoperative imaging for suspicious features.
RESULTS: Among 81 salvage TL patients undergoing END, 12 (16%) had OND and a total of 26 occult nodes were identified. On pathology, the average node length [SD] was 0.6 cm [0.3]. On CT, 31% (8 of 26) had rounded morphology. On PET, most had SUVmax below blood pool. One patient scored NI-RADS 2; the rest scored 1.
CONCLUSIONS: On re-review of preoperative imaging, occult nodes were subtle and challenging to identify. Despite no clear impact on survival, performing an END may provide prognostic information.
METHODS: A retrospective study on all patients who had OND during salvage TL with elective neck dissection (END) between 2009 and 2021 was performed. Repeat CT and PET scan interpretation was performed to evaluate their preoperative imaging for suspicious features.
RESULTS: Among 81 salvage TL patients undergoing END, 12 (16%) had OND and a total of 26 occult nodes were identified. On pathology, the average node length [SD] was 0.6 cm [0.3]. On CT, 31% (8 of 26) had rounded morphology. On PET, most had SUVmax below blood pool. One patient scored NI-RADS 2; the rest scored 1.
CONCLUSIONS: On re-review of preoperative imaging, occult nodes were subtle and challenging to identify. Despite no clear impact on survival, performing an END may provide prognostic information.
摘要：
背景：临床-N0挽救全喉切除术（TL）期间的隐匿性淋巴结疾病（OND）可以通过颈部成像报告和数据系统（NI-RADS）检测。然而,一些患者在最终病理上仍有OND显示。
方法：对2009年至2021年期间在选择性颈淋巴结清扫术（END）抢救TL期间发生OND的所有患者进行了回顾性研究。重复进行CT和PET扫描解释以评估其术前成像的可疑特征。
结果：在81例接受END的救助TL患者中，12例（16％）患有OND，总共鉴定出26个隐匿性节点。在病理学上，平均节点长度[SD]为0.6cm[0.3]。在CT上,31%(26个中的8个)具有圆形形态。在PET上,大多数人的SUVmax低于血池。一名患者NI-RADS评分为2分；其余得分为1分。
结论：关于术前影像学的重新审查，隐匿性节点是微妙的，难以识别。尽管对生存没有明显影响，执行END可以提供预后信息。
方法：对2009年至2021年期间在选择性颈淋巴结清扫术（END）抢救TL期间发生OND的所有患者进行了回顾性研究。重复进行CT和PET扫描解释以评估其术前成像的可疑特征。
结果：在81例接受END的救助TL患者中，12例（16％）患有OND，总共鉴定出26个隐匿性节点。在病理学上，平均节点长度[SD]为0.6cm[0.3]。在CT上,31%(26个中的8个)具有圆形形态。在PET上,大多数人的SUVmax低于血池。一名患者NI-RADS评分为2分；其余得分为1分。
结论：关于术前影像学的重新审查，隐匿性节点是微妙的，难以识别。尽管对生存没有明显影响，执行END可以提供预后信息。
