{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T02:23:29Z","timestamp":1781144609076,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>We evaluate the appropriateness of current radiology size criteria (short axial diameter, SAD \u2265\u200910\u2009mm) for malignant nodes in the parotid region (PLN), and appreciate the clinical implications of the Node\u2010Reporting\u2010and\u2010Data\u2010System (Node\u2010RADS) in nasopharyngeal carcinoma (NPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Material<\/jats:title>\n                    <jats:p>NPC patients who received curative IMRT were included. Pre\u2010treatment MRI was reviewed by two radiologists to record the presence\/absence, size, and configuration of PLN, and calculated Node\u2010RADS score. Malignant PLN was defined as either fine\u2010needle aspiration (FNA) positive or the occurrence of subsequent out\u2010field in\u00a0situ PLN failure following parotid\u2010sparing IMRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pre\u2010treatment PLN was identified in 74 (11.8%) of 627 consecutive patients. SAD PLNs were 5\u20136\u2009mm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200953, 72%), 6\u20138\u2009mm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915, 20%), 8\u201310\u2009mm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094, 5%), and\u2009\u2265\u200910\u2009mm (2, 3%), respectively. FNAs were positive in 6 patients (2 each in SAD 6\u20138\u2009mm, 8\u201310\u2009mm, and\u2009\u2265\u200910\u2009mm). Out\u2010field in\u00a0situ PLN failure occurred in 6 patients: 1 with SAD 5\u20136\u2009mm, 3 with SAD 6\u20138\u2009mm, and 2 with SAD 8\u201310\u2009mm. The risk of PLN being malignant was 1.9% (1\/53), 33.3% (5\/15), 100% (4\/4), and 100% (2\/2) in SAD 5\u20136\u2009mm, 6\u20138\u2009mm, 8\u201310\u2009mm, and\u2009\u2265\u200910\u2009mm subsets, respectively. Malignant PLN with Node\u2010RADS score \u2265\u20094 were 10% (1\/10), 45.5% (5\/11), and 100% (4\/4) in SAD 5\u20136\u2009mm, 6\u20138\u2009mm, 8\u201310\u2009mm subsets, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current radiologic size criteria of \u2265\u200910\u2009mm for positive PLN should be reduced to \u2265\u20098\u2009mm. Node\u2010RADS score of 4\u20135, which includes adverse morphological nodal features, could improve the specificity of identifying malignant PLNs in the 6\u20138\u2009mm subset.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70096","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T11:57:41Z","timestamp":1765195061000},"page":"1045-1053","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Appraisal of Radiologic Size Criteria for Malignant Lymph Nodes in Parotid Region in Nasopharyngeal Carcinoma: Implication for Parotid\u2010Sparing\n                    <scp>IMRT<\/scp>"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4091-8014","authenticated-orcid":false,"given":"Qiaojuan","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou China"},{"name":"Fujian Key Laboratory of Translational Cancer Medicine  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinlan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou 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