Oral cancer staging established by magnetic resonance imaging

Abstract

The aim of this study was to compare clinical staging and magnetic resonance imaging (MRI) staging for oral cancer, and to assess inter-observer agreement between oral and medical radiologists. A total of 10 patients diagnosed with oral cancer were assessed before treatment. A head and neck surgeon performed clinical TNM staging. Two medical radiologists and two oral radiologists performed a new staging assessment by interpreting MRI scans, without prior knowledge of the clinical staging. They evaluated the extent of the primary tumor (T), metastasis to regional lymph nodes (N) and grouping by stages. The data were analyzed using the Kappa Index. There was significant agreement (p < 0.05) between the clinical and MRI staging assessments made by one oral radiologist for N stage, and between those made by one medical radiologist for the T and N stages and for the grouping by stages. In the MRI assessment, there was significant agreement among all four observers for both T stage and grouping by stages. For the N stage, there was no significant agreement between one oral radiologist and one medical radiologist or between both medical radiologists. There was significant agreement among the remaining radiologists. There was no agreement between the clinical and MRI staging. These results indicate the importance of using MRI for the diagnosis of oral cancer. Training initiatives and calibration of medical and oral radiologists should be promoted to provide an improved multidisciplinary approach to oral cancer.

Oral cancer imaging: the principles of interpretation on dental radiograph, CT, CBCT, MRI, and USG

“…23 Keunggulan utama MRI antara lain tidak menggunakan radiasi pengion serta sangat baik dalam menyajikan citra jaringan lunak. 19,34 Prinsip kerja MRI adalah dengan memanfaatkan perubahan arah proton suatu partikel inti atom dengan muatan positif dalam medan magnet. Atom paling sederhana dalam tubuh adalah hidrogen, yang memiliki 1 proton dalam intinya dan 1 elektron pada orbitnya.…”

“…Sebaliknya, tumor dengan ketebalan lebih dari 9 mm memiliki probabilitas rekurensi sebesar 24%, dan tingkat bertahan hidup selama 5 tahun pada kondisi tersebut hanya 66%. 41 Modalitas MRI tidak menggunakan radiasi pengion dan tidak berpotensi merusak sel-sel tubuh, 19 namun pasien yang memiliki implan logam dan penderita klaustrofobia tidak dapat menjalani pemeriksaan MRI. Disamping itu, gerakan pasien saat pemeriksaan MRI akan menghasilkan artefak yang mengganggu proses interpretasi.…”

“…Standar baku emas diagnosis kanker oral ditegakkan berdasarkan hasil pemeriksaan histopatologis pada spesimen hasil biopsi, sedangkan penetapan stadium klinik kanker oral ditentukan berdasarkan hasil pemeriksaan klinis dan imejing diagnostik. 5,19,20 Imejing diagnostik pada kasus kanker oral diperlukan terutama untuk membantu menentukan stadium klinis berdasarkan perluasan tumor primer, metastase pada limfonodi regional, dan sejauh mana metastasenya, 19 serta untuk menentukan jenis perawatan yang paling tepat bagi pasien. 21 Tinjauan pustaka ini ditujukan untuk mengulas berbagai modalitas imejing diagnostik pada kasus kanker oral serta keunggulan dan kekurangan dari masing-masing modalitas imejing.…”

Bildgebung zur Operationsplanung

“…Die MRT hat gegenüber der CT zusätzlich den Vorteil, dass nur geringe Metallartefakte durch die meist vorhandenen Zahnimplantate auftreten, während diese in der CT häufig die Region völlig unbeurteilbar machen. Die exakte Ausdehnung des Tumors in den Zungenkörper und die Mundbodenmuskulatur ist nur mit der MRT möglich und von besonderer Bedeutung für die Therapieplanung [11] -insbesondere für die notwendige Rekonstruktion mit entsprechenden Transplantaten.…”

A method for the geometric standardization of intraoral radiographs for long‐term follow up of replanted teeth: a case report

“…Digital radiographic imaging techniques minimize the exposure of patients to radiation, reduce the image acquisition time and limit the environmental contamination, while at the same time providing high‐resolution, high‐quality images that may improve the diagnostic interpretation of radiographic findings in terms of reliability and accuracy . Digital radiography , conventional computed tomography , cone‐beam computed tomography , magnetic resonance imaging , subtraction radiography and computer‐assisted analysing systems for processing and manipulation of non‐standardized conventional radiographs (e.g. digital adjustment of brightness and contrast) are very useful resources for establishment of diagnosis and treatment plan in different areas of dentistry.…”