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August 1991

Improving Diagnostic Accuracy of Cervical Metastases With Computed Tomography and Magnetic Resonance Imaging

Arch Otolaryngol Head Neck Surg. 1991;117(8):933. doi:10.1001/archotol.1991.01870200127027

To the Editor.—I am writing to take issue with the conclusions and recommendations made by Hillsamer et al, in the November 1990 issue of the Archives1 regarding the preoperative use of computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of the clinically negative neck.

Their recommendation for the use of CT or MRI in the preoperative evaluation of the clinically negative neck is not at all supported by the authors' data as presented. The results are based on 27 patients who underwent radical neck dissections for head and neck cancer. However, of those 27 patients, 16 had clinically positive necks and in 15 of those 16, pathologic findings confirmed the clinical impression. In case 25, the physical examination results were positive and the pathologic findings were negative. It should be noted that in this situation, the CT was positive and the MRI was negative. There