Accuracy of imaging methods for detection of bone tissue invasion in patients with oral squamous cell carcinoma

Abstract

The objective of this review is to evaluate the diagnostic accuracy of imaging methods for detection of mandibular bone tissue invasion by squamous cell carcinoma (SCC). A systematic review was carried out of studies in MEDLINE, SciELO and ScienceDirect, published between 1960 and, in English, Spanish or German, which compared detection of mandibular bone tissue invasion via different imaging tests against a histopathology reference standard. Sensitivity and specificity data were extracted from each study. The outcome measure was diagnostic accuracy. We found 338 articles, of which 5 fulfilled the inclusion criteria. Tests included were: CT (four articles), MRI (four articles), panoramic radiography (one article), positron emission tomography (PET)/CT (one article) and cone beam CT (CBCT) (one article). The quality of articles was low to moderate and the evidence showed that all tests have a high diagnostic accuracy for detection of mandibular bone tissue invasion by SCC, with sensitivity values of 94% (MRI), 91% (CBCT), 83% (CT) and 55% (panoramic radiography), and specificity values of 100% (CT, MRI, CBCT), 97% (PET/CT) and 91.7% (panoramic radiography). Available evidence is scarce and of only low to moderate quality. However, it is consistently shown that current imaging methods give a moderate to high diagnostic accuracy for the detection of mandibular bone tissue invasion by SCC. Recommendations are given for improving the quality of future reports, in particular provision of a detailed description of the patients' conditions, the imaging instrument and both imaging and histopathological invasion criteria.

AHNS Series: Do you know your guidelines? Evidence‐based management of oral cavity cancers

“…Kolk et al posit that the combination of CT/SPECT can improve sensitivity and specificity of detecting bony disease, ultimately decreasing false negative and false positive findings that can be associated with conventional CT and MRI imaging . Indeed, a systematic review by Uribe et al in 2013 looked at 5 studies and 130 tumors and concluded that CT and MRI demonstrated the greatest sensitivity (94% and 91%, respectively) and specificity (100%) in detecting mandibular invasion compared with CBCT (83% and 97%, respectively) PET/CT (53% and 97%, respectively), and panoramic X‐ray (55% and 92%, respectively). Other studies demonstrate that an MRI and a bone scan can overestimate mandibular involvement (with more false‐positive results), and that CT, panorex, and clinical examination are the optimal means by which to assess bone invasion …”

High-resolution cone-beam computed tomography for assessment of bone invasion in oral cancer: Comparison with conventional computed tomography

“…Multislice CT and MRI are currently the most widely accepted imaging modalities for staging oral cavity cancer and determining bony invasion . Less utilized imaging modalities include panoramic radiography, single photon emission CT and positron emission tomography . To date, no single or combined evaluation modality has proven to be completely accurate as judged by pathology specimen reports …”

“…3 Less utilized imaging modalities include panoramic radiography, single photon emission CT and positron emission tomography. 4 To date, no single or combined evaluation modality has proven to be completely accurate as judged by pathology specimen reports. [1][2][3][4][5] Cone-beam CT (CBCT) is a relatively new imaging modality that utilizes a cone shaped X-ray beam to capture a 3D image in one sweep.…”

Positron Emission Tomography/Magnetic Resonance Imaging Practices in Oncological Imaging

“…Primer tümörün değerlendirilmesinde, lezyon sınırlarının, prevertebral boşluk infiltrasyonunun belirlenmesinde, kafa tabanına yakın veya intrakraniyal uzanım gösteren tümörlerin değerlendirilmesinde, derin dil kaslarına invazyon varlığının saptanmasında PET/MR, MR komponentinin yüksek yumuşak doku kontrastı nedeniyle PET/BT'den daha iyi tanısal performans gösterir. BT'nin ise özellikle primer tümörün kemik korteksine invazyonunu göstermede MR'dan üstün olabileceği belirtilmiştir (34).…”