Extranodal extension of tumour on histopathology is known to be a negative prognostic factor in head and neck cancer. Compelling evidence suggests that extranodal extension detected on radiological imaging is also a negative prognostic factor. Furthermore, if imaging detected extranodal extension could be identified reliably before the start of treatment, it could be used to guide treatment selection, as patients might be better managed with non-surgical approaches to avoid the toxicity and cost of trimodality therapy (surgery, chemotherapy, and radiotherapy together). There are many aspects of imaging detected extranodal extension that remain unresolved or are without consensus, such as the criteria to best diagnose them and the associated terminology. The Head and Neck Cancer International Group conducted a five-round modified Delphi process with a group of 18 international radiology experts, representing 14 national clinical research groups. We generated consensus recommendations on the terminology and diagnostic criteria for imaging detected extranodal extension to harmonise clinical practice and research. These recommendations have been endorsed by 19 national and international organisations, representing 34 countries. We propose a new classification system to aid diagnosis, which was supported by most of the participating experts over existing systems, and which will require validation in the future. Additionally, we have created an online educational resource for grading imaging detected extranodal extensions.

中文翻译：

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头颈癌放射成像检测到的结外扩散的诊断标准：头颈癌国际小组共识建议


已知组织病理学上肿瘤的结外扩展是头颈癌的负面预后因素。令人信服的证据表明，放射成像检测到的结外扩展也是一个负面的预后因素。此外，如果在治疗开始前能够可靠地识别影像学检测到的结外扩展，则它可以用于指导治疗选择，因为患者可以通过非手术方法得到更好的管理，以避免三联治疗（手术、化疗）的毒性和成本。 ，和放射治疗一起）。影像学检测结外扩散的许多方面仍未解决或没有达成共识，例如最佳诊断标准和相关术语。头颈癌国际小组与代表 14 个国家临床研究小组的 18 名国际放射学专家组成的小组进行了五轮改良德尔菲法。我们就影像检测结外扩散的术语和诊断标准提出了共识建议，以协调临床实践和研究。这些建议已得到代表 34 个国家的 19 个国家和国际组织的认可。我们提出了一种新的分类系统来辅助诊断，该系统得到了大多数参与专家对现有系统的支持，并且需要在未来进行验证。此外，我们还创建了一个在线教育资源，用于对成像检测到的结外扩展进行分级。