Goos, David (2026) Evaluating the Necessity of Fine-Needle Aspiration Cytology in Preoperative Staging of Oral Squamous Cell Carcinoma. thesis, Medicine.
Full text available on request.Abstract
Background: Oral squamous cell carcinoma (OSCC) most commonly metastasizes to regional neck lymph nodes, making accurate preoperative staging is crucial for treatment planning. In current practice, radiological assessment using MRI and ultrasound is followed by ultrasound-guided fine-needle aspiration cytology (FNAC) when metastasis is suspected. The added value of FNAC compared to imaging alone remains uncertain. Methods: A retrospective cohort study was conducted in 232 OSCC patients treated at Medisch Spectrum Twente (2019–2023), comprising 617 reported lymph nodes. Radiological findings, FNAC results, and postoperative histopathology were collected. Diagnostic parameters (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV)) were calculated for imaging and FNAC. The short-axis diameter was analyzed as a predictor of FNAC outcome. Results: MRI showed the highest sensitivity (67.9%) and NPV (85.8%) among imaging modalities. FNAC achieved superior specificity (95.9%) and PPV (92.3%). FNAC performed on MRI-negative nodes (n=19) yielded two false-positive results. Short-axis diameter was significantly associated with positive FNAC, with an AUC of 0.74 for MRI and 0.77 for ultrasound. Conclusion: FNAC increases specificity but not overall sensitivity of preoperative staging. MRI�negative lymph nodes strongly predict negative FNAC results, suggesting that FNAC could be omitted in selected cases. Refining radiological criteria may improve diagnostic efficiency, patient comfort, and resource utilization.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Huizinga, Martin (PI), MSc, MD, DMD and Kok, Marius MSc, MD, |
| Faculty: | Medical Sciences |
| Date Deposited: | 20 Oct 2026 12:42 |
| Last Modified: | 20 Oct 2026 12:42 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3980 |
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