CRISPS – An Easy Acronym to Interpreting Metastatic Neck Lymphadenopathy

Purpose: To present a pictorial review showing the various radiologic features of metastatic lymphadenopathy in skull base cancer.

Materials and Methods: The viewer will learn about the critical imaging features of malignant skull base adenopathy. We have developed an easy to remember acronym called “CRISPS” which incorporates the various imaging features that one should evaluate on cross sectional imaging studies of the skull base.

Results: The presence of metastatic neck lymphadenopathy is the most important prognostic indicator in skull base malignancy, significantly reducing prognosis. CRISPS is an acronym that represents Clustering, Rounded, Inhomogeneity, Size, Peripheral Spread and Sentinel . These are important radiologic features of metastatic lymphadenopathy that one needs to be familiar with when evaluating skull base studies. The principle and application of CRISPS will be illustrated using images from multiple modalities, including CT, MRI, PET and ultrasound.

Conclusion: Differentiation between benign and malignant neck lymphadenopathy is important in staging of skull base cancer. This exhibit reviews the spectrum of imaging findings of malignant adenopathy and will help in accurately detecting disease.