Clinical impact of short tau inversion recovery MRI on staging and management in patients with cervical lymph node metastases of head and neck squamous cell carcinomas

Background. We investigated the incremental diagnostic value of short tau inversion recovery (STIR) MRI to detect cervical nodal metastases in head and neck squamous cell carcinoma. Methods. Thirty-six patients with cervical nodal metastases underwent MRI preceding neck dissection. Two readers evaluated MRI versus MRI with STIR. Level-based analysis was performed: interobserver agreements (kappa) for detecting normal and metastatic lymph nodes; sensitivities and specificities for detecting at least 1 metastatic lymph node per level; linear regression analysis to determine performances of MRI with STIR in detecting correct numbers of normal and metastatic lymph nodes. Histopathology was the reference standard. Results. One hundred eighty neck levels were evaluated. MRI with STIR showed better kappas for metastatic and normal lymph nodes, was more accurate to estimate numbers of metastatic and normal lymph nodes, and showed improvement of sensitivities and specificities. Conclusion. Incorporation of STIR into the conventional MR protocol significantly improves the detection of cervical lymph node metastases.