Tokez S, Koekelkoren FHJ, Grünhagen DJ, et al. - For detection of metastasis of high-risk cutaneous squamous cell carcinoma (SCC) of the head and neck, a higher sensitivity is yielded by ultrasonography vs clinical examination; however, ultrasonography also had a high rate of false-positive results in this study.

• A total of 233 patients with 246 high-risk cutaneous SCC tumors of the head and neck were included to determine the diagnostic accuracy of clinical examination and baseline ultrasonography for the detection of metastasis and to evaluate the precision of ultrasonography when baseline clinical examination generates negative results.

• Cytologically confirmed metastases were 22 (9%).

• Clinical examination had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 50%, 96%, 55% and 95%, respectively.

• In the overall cohort, ultrasonography conferred sensitivity, specificity, PPV and NPV of 91%, 78%, 29% and 99%, respectively.

• In cases with negative results at baseline clinical examination, ultrasonography identified 9 of 11 metastases, with 82% sensitivity; specificity was 79%, PPV was 17%, and NPV was 99%.