Comparison of different diagnostic imaging techniques for the detection of bone invasion in oral cancers
Comparison of different diagnostic imaging techniques for the detection of bone invasion in oral cancers
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DOI：
10.1016/j.oraloncology.2021.105453
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发表时间：
2021-07-12
期刊：
影响因子：
4.8
通讯作者：
Takahashi, Tetsu
中科院分区：
文献类型：
--
作者：
Kouketsu, Atsumu;Miyashita, Hitoshi;Takahashi, Tetsu
目的：评价不同影像学检查方法对口腔鳞状细胞癌骨侵犯的准确诊断能力。患者与方法：口腔鳞状细胞癌患者，谁是预定的下颌骨或上颌骨切除术，进行了临床评价，术前影像诊断方法，增强MRI，CT，99 mTc扫描（Tc扫描），FDG-PET CT（PET/CT），和全景摄影。通过将影像学检查结果与术后组织病理学检查结果进行比较，计算每种检查方法检测骨浸润的敏感性和特异性。在一个患者亚组中，我们进一步评估了MRI和CT检测骨侵犯准确程度的能力，包括病理性下颌骨侵犯患者的高度、宽度和深度。结果如下：总体而言，50例患者参加了这项研究，9例病理性下颌骨侵犯患者被纳入我们的亚组分析。MRI是诊断骨侵犯最有效的方法，其敏感性最高（88.9%），阴性预测值最高（92.3%）。CT的特异性和敏感性分别为87.5%和77.8%，高于MRI，但敏感性稍差。PET/CT联合诊断的敏感性（83.3%）高于CT，特异性（71.9%）低于CT。Tc扫描敏感性高（88.9%），但特异性较低（71.9%）。结论：MRI是诊断骨侵犯最有效的方法。阴性MRI结果明确排除骨髓浸润。在MRI阳性的患者中，CT阴性可能有助于排除骨髓侵犯。
Objectives: To evaluate the ability of different imaging modalities to accurately detect bone invasion in oral squamous cell carcinomas. Patients and Methods: Patients with oral squamous cell carcinoma, who were scheduled for mandibulectomy or maxillectomy, underwent clinical evaluation using five preoperative imaging diagnosis methods-contrastenhanced 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. Results: 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%). Conclusion: 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.