Purpose: The aim of the present study was to demonstrate the rating of low-flow color duplex echography in the staging of head and neck cancer.
Patients and methods: Fifty-two patients with squamous cell carcinoma of the oral cavity, the oropharynx, and hypopharynx were examined. A Siemens Q 2000 duplex scan with 7.5 MHz-linear array and wedge (Siemens Medizintechnik, Siemens Medical Systems, Erlangen, Germany) was used. Gray scale imaging as well as color duplex scan with Doppler spectrum measurement were performed for each patient.
Results: Only 5 of 52 primary tumors could not be detected using echography (sensitivity: 90%). Tumor size of one carcinoma, a recurrent tumor of the laryngeal sinus, was overestimated (predictive value: 96%). The carcinomas and their metastases were poorly vascularized. Only 10 of 52 primary tumors showed central vascularization. The mean systolic flow rate in these vessels was 40 cm/s. In 17 patients, imaging of peripheral tumor vessels improved estimation of tumor borders. Imaging of irregular central tumor vessels in metastatic lymphatic nodes yielded important information for N staging.
Conclusion: Low-flow color duplex echography is a new high resolution, noninvasive imaging technique that offers important additional information for preoperative head and neck tumor staging. Thus, it should be recommended for routine application in ENT-oncology.