Comparison of different diagnostic imaging techniques for the detection of bone invasion in oral cancers

• Published in: Oral oncology Vol. 120; p. 105453
• Main Authors: Kouketsu, Atsumu, Miyashita, Hitoshi, Kojima, Ikuho, Sakamoto, Maya, Murata, Takaki, Mori, Shiro, Nogami, Shinnnosuke, Yamauchi, Kensuke, Nagai, Hirokazu, Kumamoto, Hiroyuki, Takahashi, Tetsu
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-09-2021
• Subjects: Diagnostic imaging; Fluorodeoxyglucose F18; Humans; Magnetic Resonance Imaging; Mandible - pathology; Mouth Neoplasms - diagnostic imaging; MRI scans; Negative predictive value; Neoplasm Invasiveness - diagnostic imaging; Oral cancers; Oral squamous cell carcinoma; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Sensitivity and Specificity; Squamous Cell Carcinoma of Head and Neck - diagnostic imaging; Tomography, X-Ray Computed; MRI scans; OSCC; PR; MRI; Negative predictive value; FDG; Diagnostic imaging; Oral squamous cell carcinoma; Oral cancers; FOV; CT; TE; SE; FSE; PET; TR; WHO
• DOI: 10.1016/j.oraloncology.2021.105453
• EISSN: 1879-0593
• ISSN: 1368-8375

•Magnetic resonance imaging—most reliably detects bone invasion in oral cancers.•A negative MRI result definitively excludes bone marrow invasion.•In positive MRI findings, a negative CT may rule out bone marrow invasion.
To evaluate the ability of different imaging modalities to accurately detect bone invasion in oral squamous cell carcinomas.
Patients with oral squamous cell carcinoma, who were scheduled for mandibulectomy or maxillectomy, underwent clinical evaluation using five preoperative imaging diagnosis methods—contrast-enhanced MRI, CT, 99mTc scintigraphy (Tc scan), FDG-PET CT (PET/CT), and panoramic radiography. The sensitivity and specificity of each modality in detecting bone invasion were calculated by comparing the findings on the images with postoperative histopathological findings. In a subgroup of patients, we further assessed the ability of MRI and CT to detect the accurate extent of bone invasion, including the height, width, and depth in patients with pathological mandibular invasion.
Overall, 50 patients were enrolled in this study, and nine patients with pathological mandibular invasion were included in our subgroup analysis. MRI was found to be the most useful method in detecting bone invasion, showing the highest sensitivity (88.9%) and negative predictive values (92.3%). CT (87.5% specificity and 77.8% sensitivity) was more specific than MRI, though less sensitive. Combined PET/CT was more sensitive (83.3%) and less specific (71.9%) than CT. Tc scan had high sensitivity (88.9%); however, the specificity was relatively low (71.9%).
MRI was the most useful method in detecting bone invasion. A negative MRI result definitively excludes bone marrow invasion. In patients with positive MRI findings, a negative CT may be useful in ruling out bone marrow invasion.