Lo W.-C.Cheng P.-W.Shueng P.-W.Hsieh C.-H.YIH-LEONG CHANGLiao L.-J.2020-03-072020-03-0720181749-4478https://www.scopus.com/inward/record.uri?eid=2-s2.0-85043693990&doi=10.1111%2fcoa.12998&partnerID=40&md5=1f638565092bbf49ef5cb2eff11c140dhttps://scholars.lib.ntu.edu.tw/handle/123456789/473736Objective: To establish a real-time predictive scoring model based on sonographic characteristics for identifying malignant cervical lymph nodes (LNs) in cancer patients after neck irradiation. Methods: One-hundred forty-four irradiation-treated patients underwent ultrasonography and ultrasound-guided fine-needle aspirations (USgFNAs), and the resultant data were used to construct a real-time and computerised predictive scoring model. This scoring system was further compared with our previously proposed prediction model. Results: A predictive scoring model, 1.35 × (L axis) + 2.03 × (S axis) + 2.27 × (margin) + 1.48 × (echogenic hilum) + 3.7, was generated by stepwise multivariate logistic regression analysis. Neck LNs were considered to be malignant when the score was ? 7, corresponding to a sensitivity of 85.5%, specificity of 79.4%, positive predictive value (PPV) of 82.3%, negative predictive value (NPV) of 83.1%, and overall accuracy of 82.6%. When this new model and the original model were compared, the areas under the receiver operating characteristic curve (c-statistic) were 0.89 and 0.81, respectively (P <.05). Conclusions: A real-time sonographic predictive scoring model was constructed to provide prompt and reliable guidance for USgFNA biopsies to manage cervical LNs after neck irradiation. ? 2017 John Wiley & Sons Ltdfine-needle aspiration biopsy; head and neck; lymph node; prediction model; radiotherapy; ultrasound[SDGs]SDG3adult; aged; area under the curve; Article; cancer radiotherapy; cervical lymph node metastasis; diagnostic accuracy; diagnostic test accuracy study; echography; esophagus cancer; female; fine needle aspiration biopsy; head and neck cancer; human; larynx cancer; major clinical study; male; mouth cancer; multivariate logistic regression analysis; nasopharynx carcinoma; oropharynx carcinoma; prediction; predictive value; priority journal; receiver operating characteristic; reliability; scoring system; sensitivity and specificity; diagnostic imaging; head and neck tumor; lymph node; lymph node metastasis; middle aged; pathology; secondary; statistical model; Adult; Aged; Biopsy, Fine-Needle; Female; Head and Neck Neoplasms; Humans; Logistic Models; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Predictive Value of Tests; ROC Curve; Ultrasonographyjournal article10.1111/coa.12998289812042-s2.0-85043693990