Accuracy of Mri in Prediction of Tumour Thickness and Nodal Stage in Oral Tongue and Gingivobuccal Cancer With Clinical Correlation and Staging
Introduction: Squamous cell carcinoma of lower gingivobuccal complex and tongue are the most common cancer in the Indian sub-continent. The value of imaging in the staging of Oral Squamous Cell Carcinoma (OSCC) is in judging operability, assessment of the prognostic characteristics and dimensions...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-06-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/7905/17411_CE(Ra1)_F(GH)_PF1(ROAK)_PFA(AK)_PF2(EKAK).pdf |
| Summary: | Introduction: Squamous cell carcinoma of lower gingivobuccal complex and tongue are the most common cancer in
the Indian sub-continent. The value of imaging in the staging of
Oral Squamous Cell Carcinoma (OSCC) is in judging operability,
assessment of the prognostic characteristics and dimensions
of the primary tumour, depth of tumour invasion, the presence
of cervical metastasis and detection of bone infiltration.
Aim: This study evaluated squamous cell carcinomas of the oral
cavity (tongue and gingivo-buccal complex) on the basis of their
appearance, soft tissue extent, depth of tumour invasion and
staging. Further, this study assessed the accuracy of MRI in the
detection of cervical lymph nodal metastasis on the basis of
ADC values on diffusion weighted MR sequence.
Materials and Methods: T1- and T2-weighted MR, diffusionweighted sequences and post contrast T1W sequences were
performed in various planes on biopsy proven squamous cell
carcinomas (61 cases) involving tongue and/or gingivo-buccal
region. Depth of tumour invasion was calculated on axial
images of post contrast T1W images. The Apparent Diffusion
Coefficient (ADC) was measured by using two b factors (500
and 1000 s/mm2
). MRI findings were compared clinically and
histopathologically.
Results: Average depth of invasion calculated on MRI was
8.47mm and by histopathology was 6.85mm. Pearson's
correlation coefficient was 0.988. Shrinkage factor was 0.8.
A 71% of patients with depth of invasion greater than 9mm
showed evidence of cervical lymph nodal metastasis at one or
another levels. Cut-off value to discriminate between malignant
and benign lymph nodes was 1.038 x10-3 mm2
/s in the present
study.
Conclusion: Depth of tumour invasion in oral malignancies can
be measured reliably on MRI which helps in predicting cervical
lymph node metastasis. Benign or malignant cervical lymph
nodes can be differentiated on diffusion-weighted imaging of
MRI on the basis of their ADC values. |
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| ISSN: | 2249-782X 0973-709X |