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International Journal of Surgical Oncology
Volume 2013, Article ID 968758, 6 pages
Clinical Study

Value of MR and CT Imaging for Assessment of Internal Carotid Artery Encasement in Head and Neck Squamous Cell Carcinoma

1Department of Head & Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
2Department of Otorhinolaryngology/Head and Neck Surgery, The University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
3Department of Radiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
4Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
5Department of Otorhinolaryngology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
6Institute of Phonetic Sciences, ACLC, University of Amsterdam, Amsterdam, The Netherlands

Received 25 November 2012; Accepted 4 January 2013

Academic Editor: Masaki Mori

Copyright © 2013 W. L. Lodder et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. This study was conducted to assess the value of CT and MR imaging in the preoperative evaluation of ICA encasement. Methods. Based upon three patient groups this study was performed. Retrospective analysis of 260 neck dissection reports from 2001 to 2010 was performed to determine unexpected peroperative-diagnosed encasement. Two experienced head and neck radiologists reviewed 12 scans for encasement. Results. In four out of 260 (1.5%) patients undergoing neck dissection, preoperative imaging was false negative as there was peroperative encasement of the ICA. Of 380 patients undergoing preoperative imaging, the radiologist reported encasement of the ICA in 25 cases. In 342 cases no encasement was described, 125 of these underwent neck dissection, and 2 had encasement peroperatively. The interobserver variation kappa varied from 0.273 to 1 for the different characteristics studied. Conclusion. These retrospectively studied cohorts demonstrate that preoperative assessment of encasement of the ICA using MRI and/or CT was of value in evaluation of ICA encasement and therefore contributively in selecting operable patients (without ICA encasement), since in only 1.5% encasement was missed. However, observer variation affects the reliability of this feature.