Objectives: Accurate assessment of neck lymphadenopathy is crucial in Oral Squamous Cell Carcinoma (OSCC) due to its prognostic significance. This study aimed to evaluate the reliability and validity of radiological tools using histopathology as a reference for assessing cervical lymph nodes in these patients. Methods: A cross-sectional study was conducted involving 30 patients with OSCC, selected through purposive sampling, who underwent neck dissection at Kenyatta National Hospital between February and June 2023. Data from radiological (preoperative) and histopathological (postoperative) assessment of cervical lymph nodes was collected. The agreement, sensitivity, and specificity of different radiological examinations were evaluated. Results: Radiological and pathological nodal categories showed a consensus (κ = 0.629, p = 0.009), reporting CT scan sensitivity was 83.3% (51.6 - 97.9) and MRI sensitivity was 100% (39.8 - 100). Specificity for CT scan was 44.4% (13.7 - 78.8), while specificity for MRI was 60% (14.7 - 94.7). The positive predictive values for CT scan and MRI were 66.7% (51.4 - 79.1) each while the negative predictive values were 66.7% (40.6 - 85.4) and 100%, respectively. Conclusions: The radiological diagnostic tools demonstrated varying levels of reliability, with MRI showing higher validity than CT scan in the assessment of cervical lymph nodes in OSCC patients.
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