A retrospective study evaluated 58 patients (167 lymph nodes) with head and neck squamous cell carcinoma (HNSCC) using contrast-enhanced CT and MRI. Assessment of positive nodal involvement was based on the finding of at least 2 of 6 radiologic criteria (rN+). For all rN+, radiologic extranodal extension was analyzed, with positive extension (rENE+) if defined by the presence of at least 1 of 3 selected radiologic criteria. The findings showed 89% agreement between imaging and histology for rN+ assessment (k = 0.7) and 78% agreement, indicating moderate concordance (k = 0.5), for rENE+ evaluation. No significant differences were observed between CT and MRI in the accuracy of assessment of nodal involvement and extranodal extension.
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