Comparison of PET/CT and MRI for the detection of bone marrow invasion in patients with squamous cell carcinoma of the oral cavity
Comparison of PET/CT and MRI for the detection of bone marrow invasion in patients with squamous cell carcinoma of the oral cavity
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DOI：
10.1016/j.oraloncology.2011.02.010
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发表时间：
2011-04-01
期刊：
影响因子：
4.8
通讯作者：
Yen, Tzu-Chen
中科院分区：
文献类型：
--
作者：
El-Hafez, Yasser G. Abd;Chen, Chien-Cheng;Yen, Tzu-Chen
我们的目的是回顾评估正电子发射断层扫描/计算机断层扫描(PET/CT)和磁共振成像(MRI)联合检查对口腔鳞状细胞癌(OCSCC)患者下颌骨骨髓侵犯的诊断价值。在PET/CT和MRI上对骨髓侵犯的可能性进行了5分的回顾性评分。以组织病理学为参考标准。计算敏感度、特异度、预测值和似然比。临床因素的影响，如肿瘤来源和齿状状态，发现PET/CT比磁共振更具特异性(分别为83%和61%，p=0.0015)，但敏感性较低(分别为78%和97%，p=0.0391)。牙齿状态和肿瘤来源影响PET/CT的诊断性能。在MRI阳性患者中，PET/CT对齿状肿瘤的敏感性和特异性分别为78%和100%，对齿状肿瘤的敏感性和特异性分别为75%和80%，对无牙颌肿瘤的敏感性和特异性分别为90%和33%，对口腔肿瘤的敏感性和特异性分别为0%和63%，PET/CT比MRI更具特异性，可作为MRI的补充。MRI检查结果阴性可排除骨髓侵犯的存在，而在MRI检查阳性的患者中，PET/CT阴性可能有助于排除齿状突起患者的骨髓侵犯。(C)2011爱思唯尔有限公司。保留所有权利。
Our aim was to retrospectively assess the diagnostic performance from combined positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) for the detection of bone marrow invasion of the mandible or maxilla in patients with oral cavity squamous cell carcinoma (OCSCC).A total of 114 patients with OCSCC, arising from or abutting the upper or lower alveolar ridge, underwent staging PET/CT and MRI studies before surgery. The possibility of bone marrow invasion on PET/CT and MRI was graded retrospectively on a 5-point score. Histopathology was taken as the reference standard. Sensitivity, specificity, predictive values and likelihood ratios were calculated. Clinical factors affecting the performance, like tumor origin and dentate status were also explored.PET/CT was found to be more specific than MRI (83% vs. 61%, respectively, p = 0.0015) but less sensitive (78% vs. 97%, respectively, p = 0.0391). Dentate status and tumor origin affected the diagnostic performance of PET/CT. In patients with positive MRI, sensitivity and specificity of PET/CT were 78% and 100% in dentate patients with alveolar ridge tumors, 75% and 80% in dentate patient with buccal tumors, 90% and 33% in edentulous patients with alveolar ridge tumors and 0% and 63% for edentulous patients with buccal tumors, respectively.PET/CT is more specific than MRI and can be used to complement the role of MRI. A negative MRI result can confidently exclude the presence of bone marrow invasion, while in patients with positive MRI findings, a negative PET/CT may be useful to rule out bone marrow invasion in dentate patients. (C) 2011 Elsevier Ltd. All rights reserved.