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Lo Casto A, Cannella R, Taravella R, Cordova A, Matta D, Campisi G, Attanasio M, Rinaldi G, Rodolico V. Diagnostic and prognostic value of magnetic resonance imaging in the detection of tumor depth of invasion and bone invasion in patients with oral cavity cancer. Radiol Med 2022; 127:1364-1372. [PMID: 36255660 DOI: 10.1007/s11547-022-01565-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE To evaluate the accuracy of preoperative contrast-enhanced magnetic resonance imaging (MRI) in the assessment of radiological depth of invasion (rDOI) and bone invasion in patients with oral cavity cancer, and the prognostic value of preoperative rDOI. MATERIALS AND METHODS This retrospective study included patients with surgically resected oral cavity cancer and preoperative MRI acquired within four weeks before surgery. Two readers evaluated the MRI to assess the superficial and deep bone invasion, preoperative T stage, and measured the rDOI. The rDOI was compared to the histopathological DOI (pDOI), used as reference standard. Prognostic value of preoperative features for the disease-specific survival was evaluated using the Kaplan-Meier curve and multivariable Cox proportional hazards analysis. RESULTS The final population included 80 patients (50 males, mean age 67.7 ± 13.6 years). There was a strong statistically significant correlation between the rDOI (median 10 mm) and the pDOI (median 9 mm) (ρ: 0.978, p < 0.001). The agreement between MRI and histopathological T stage was excellent (k = 0.93, 95% CI 0.86, 0.99). The sensitivity and specificity of preoperative MRI were 93.3% and 98.8% for deep bone invasion, while they were 75.0% and 95.8% for superficial bone invasion, respectively. The rDOI > 10 mm was associated with poorer disease-specific survival (log-rank p = 0.016). The rDOI remained the only independent preoperative predictor associated with poorer disease-specific survival at multivariable analysis (hazard ratio 5.5; 95% CI 1.14, 26.58; p = 0.033). CONCLUSION Preoperative MRI is accurate for the assessment of DOI and bone invasion. The rDOI is an independent preoperative predictor of disease-specific survival in patients with oral cavity cancer.
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Affiliation(s)
- Antonio Lo Casto
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (Bi.N.D.), Università degli Studi di Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Roberto Cannella
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (Bi.N.D.), Università degli Studi di Palermo, Via del Vespro 129, 90127, Palermo, Italy.
- Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", PROMISE, Università degli Studi di Palermo, Palermo, Italy.
| | | | - Adriana Cordova
- Divisione di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.), Università degli Studi di Palermo, Palermo, Italy
| | - Daniele Matta
- Divisione di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.), Università degli Studi di Palermo, Palermo, Italy
| | - Giuseppina Campisi
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.), Università degli Studi di Palermo, Palermo, Italy
| | - Massimo Attanasio
- Departmentimento di Scienze Economiche, Aziendali e Statistiche, Università degli Studi di Palermo, Palermo, Italy
| | - Gaetana Rinaldi
- Sezione di Oncologia, Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.), Università degli Studi di Palermo, Palermo, Italy
| | - Vito Rodolico
- Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", PROMISE, Università degli Studi di Palermo, Palermo, Italy
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Cao C, Gan X, He Y, Su Y, Liu Z, Hu X, Peng X. Diagnostic efficacy of PET-CT, CT, and MRI in preoperative assessment of mandibular invasion caused by head and neck cancer: A systematic review and meta-analysis. Oral Oncol 2021; 116:105264. [PMID: 33756286 DOI: 10.1016/j.oraloncology.2021.105264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/24/2021] [Accepted: 03/11/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aims to conduct a systematic review and meta-analysis of the performance of PET-CT, CT, and MRI in diagnosing mandible invasion induced by head and neck cancer (HNC). MATERIALS AND METHODS The MEDLINE, Embase, Science Direct, CNKI and CQVIP databases were searched from inception until August 1, 2020. Then, a meta-analysis was conducted to calculate the combined diagnostic values with the corresponding 95% CIs. Two independent researchers completed the full text screening, data abstraction, and risk assessment. RESULTS This meta-analysis included 53 studies (N = 2 946 participants). For the pooled sensitivity (SEN), MRI (SEN: 0.88, 95% CI: 0.81-0.93) was found to have a significantly higher SEN (P = 0.0045), when compared to CT (SEN: 0.77, 95% CI: 0.71-0.82), while compared with PET-CT (SEN: 0.88, 95% CI: 0.64-0.97), the SEN was approximately equal (P > 0.05). The analysis revealed that the combined specificity (SPE) of MRI (SPE: 0.83, 95% CI: 0.74-0.89) and PET-CT (SPE: 0.81, 95% CI: 0.57-0.93) was lower than that of CT (SPE: 0.87, 95% CI: 0.83-0.90), but there was no statistical significance among these (P > 0.05). The comparison of the area under curve (AUC) reflected that PET-CT, CT and MRI have approximately equal summary diagnostic power in detecting mandibular invasion (P > 0.05). CONCLUSION The findings suggest that compared with CT, MRI is significantly superior for higher SEN in diagnosing mandibular invasion. The SEN of MRI and PET-CT were approximately equal. For the summary of diagnostic power, more prospective clinical trials that directly compare these three methods are needed in the future.
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Nemade H, Bollineni N, Mortha S, Jonathan G, Kumar S, Rao L, Rao S. Marginal Mandibulectomy Defect Reconstruction with Pectoralis Major Myocutaneous (PMMC) Flap in Cases of Carcinoma Buccal Mucosa: Experience from a Tertiary Cancer Institute. Indian J Surg Oncol 2020; 11:482-485. [PMID: 33013132 DOI: 10.1007/s13193-020-01120-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 06/02/2020] [Indexed: 10/24/2022] Open
Abstract
Patients with carcinoma buccal mucosa requiring marginal mandibulectomy pose various key challenges with regard to reconstruction. To study the role and feasibility of the PMMC flap reconstruction in patients of carcinoma buccal mucosa with intact mandible. Study design: retrospective analysis of prospectively maintained data at a tertiary cancer institute in India. Inclusion criteria: all patients of carcinoma buccal mucosa undergoing marginal mandibulectomy at our institute from 1st Jan 2015 to 31st March 2018 with reconstruction done by the PMMC flap. The retrospective analysis showed 82 patients satisfied the inclusion criteria. Median age of the patients was 46 years. Seventy-seven (93.90%) patients were male while 5 (6.09%) patients were female. Median Ryle's tube dependency was 13 days. Median follow-up period was 28 months. All the patients had acceptable cosmesis and mouth opening with minimal morbidity. PMMC flap reconstruction after marginal mandibulectomy in patients with carcinoma buccal mucosa is a robust, cosmetically, and functionally acceptable option.
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Affiliation(s)
- Hemant Nemade
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Banjara Hills Road No 10, Hyderabad, Telangana 500034 India
| | - Naren Bollineni
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Banjara Hills Road No 10, Hyderabad, Telangana 500034 India
| | - Sagar Mortha
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Banjara Hills Road No 10, Hyderabad, Telangana 500034 India
| | - G Jonathan
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Banjara Hills Road No 10, Hyderabad, Telangana 500034 India
| | - Sravan Kumar
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Banjara Hills Road No 10, Hyderabad, Telangana 500034 India
| | - Lmcs Rao
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Banjara Hills Road No 10, Hyderabad, Telangana 500034 India
| | - Subramanyeshwar Rao
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Banjara Hills Road No 10, Hyderabad, Telangana 500034 India
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Nae A, O'Leary G, Feeley L, Fives C, Fitzgerald B, Chiriac E, Sheahan P. Utility of CT and MRI in assessment of mandibular involvement in oral cavity cancer. World J Otorhinolaryngol Head Neck Surg 2019; 5:71-75. [PMID: 31334484 PMCID: PMC6617213 DOI: 10.1016/j.wjorl.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 02/09/2019] [Accepted: 02/12/2019] [Indexed: 01/08/2023] Open
Abstract
Objective Oral cavity squamous cell carcinoma (SCC) may present with early invasion of mandibular bone. Preoperative planning of surgery is essential considering patient's postoperative quality of life. Our purpose was to evaluate the efficacy of computer tomography scan (CT) and magnetic resonance imaging (MRI) in detecting mandibular bone involvement in oral SCC. Methods A retrospective study was conducted on 98 patients with SCC of floor of mouth, lower alveolus and retromolar trigone operated on with curative intent. Preoperative CT and MRI scans were re-reviewed by a consultant radiologist and original histology slides were re-reviewed by 3 pathologists. Results Forty-five patients were included in the final study. Combined CT and MRI had a sensitivity of 100% and a specificity of 72%. Conclusion The results suggest that combined CT and MRI have diagnostic utility in detecting mandibular invasion by oral cancer, but with a significant false positive rate.
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Affiliation(s)
- Andreea Nae
- ENT Department, South Infirmary-Victoria University Hospital, Cork, Ireland
- Corresponding author. ENT Department South Infirmary-Victoria University Hospital, Old Blackrock Road, Cork, T12X23H, Ireland.
| | - Gerard O'Leary
- ENT Department, South Infirmary-Victoria University Hospital, Cork, Ireland
| | - Linda Feeley
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | - Cassie Fives
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | | | - Elena Chiriac
- Radiology Department, South Infirmary-Victoria University Hospital, Cork, Ireland
| | - Patrick Sheahan
- ENT Department, South Infirmary-Victoria University Hospital, Cork, Ireland
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Qiao X, Liu W, Cao Y, Miao C, Yang W, Su N, Ye L, Li L, Li C. Performance of different imaging techniques in the diagnosis of head and neck cancer mandibular invasion: A systematic review and meta-analysis. Oral Oncol 2018; 86:150-164. [PMID: 30409295 DOI: 10.1016/j.oraloncology.2018.09.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/06/2018] [Accepted: 09/16/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND To assess diagnostic efficacy of imaging techniques for mandibular invasion by head and neck cancer. METHODS Thirteen databases were searched. Study inclusion, data-extraction and quality assessment were performed independently. STATA 14.0 were mainly used for meta-analysis. RESULTS Forty-nine studies were included. For mandibular invasion (cortex and marrow), CBCT, SPECT, CT, MRI, orthopantomography, PET-CT and bone-scintigraphy showed pooled sensitivities of 90%, 97%, 73%, 88%, 75%, 90%, 92%, specificities of 85%, 69% 91%, 90%, 83%, 89%, 79%, AUC of 0.9461, 0.9434, 0.8995, 0.9296, 0.8761, 0.9290, 0.9207, respectively. The combined SROC curves indicated CBCT and SPECT were superior to other techniques. For mandibular medullary invasion (marrow), CT and MRI showed pooled sensitivities of 85% and 93%, specificities of 86% and 84%. CONCLUSIONS CBCT was top-priority choice for bone invasion diagnosis. SPECT was recommended for exclusion, CT and MRI were suitable for conformation. Further investigations are needed for mandibular medullary involvement.
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Affiliation(s)
- Xianghe Qiao
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Wei Liu
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Yubin Cao
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Cheng Miao
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Wenbin Yang
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Naichuan Su
- Department of Prosthodontics, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Li Ye
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Longjiang Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
| | - Chunjie Li
- Department of Head and Neck Oncology, Department of Evidence-based Dentistry, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
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