Contrast-enhanced CT and MRI for detecting neck metastasis of oral cancer: comparison between analyses performed by oral and medical radiologists

Abstract

Objectives: The aim of the study was to verify the concordance of contrast-enhanced CT (CECT) and MRI evaluation among four radiologists in detecting metastatic cervical lymph nodes of oral cancer patients. Methods: Ten patients underwent clinical and imaging examinations (CECT and MRI). Four radiologists, two oral and maxillofacial radiologists (OMRs) and two medical radiologists (MRs), independently analysed the images twice. Cohen's kappa index and Wilcoxon signed-rank test were used to verify the concordance between all analyses. Results: Regarding the interobserver agreement, the OMRs presented excellent kappa values for determining the regional lymph nodes (N-stage) in both CECT and MRI. The MRs presented moderate agreement for CECT evaluation at the first reading, but no concordance was found for the other analyses. When each imaging modality was analysed separately, kappa values were higher between all examiners. Greater variability was demonstrated between Nstage evaluation using different examinations. All radiologists were able to identify a greater number of metastatic lymph nodes in CECT than in MRI, except one MR, but no significant difference was found for all readers. The differences between the number of metastatic lymph nodes among all radiologists were not statistically significant. Moderate intraobserver agreement was observed for CECT and MRI evaluation, except for one MR. Conclusions: The differences found between the N-stage performed by OMRs and MRs support the necessity of a multidisciplinary approach in the imaging evaluation of metastatic nodes. Further studies are necessary to confirm which imaging modality should be employed when evaluating neck areas.

Diagnostic accuracy of contrast‐enhanced computed tomography for assessment of mandibular and medial retropharyngeal lymph node metastasis in dogs with oral and nasal cancer

“…Subspecialisation may also play a role, with many radiologists in human medicine focusing on specific anatomic sites or organ systems, whereas veterinary radiologists typically cover all anatomic sites for a wide range of species. Greater agreement in assessment of cervical lymph node metastasis has been reported between oral and maxillofacial radiologists when compared with medical radiologists supporting the concept that even within radiologists assessing a single species, subspecialisation provides a benefit for assessment of lymph nodes …”

“…Greater agreement in assessment of cervical lymph node metastasis has been reported between oral and maxillofacial radiologists when compared with medical radiologists supporting the concept that even within radiologists assessing a single species, subspecialisation provides a benefit for assessment of lymph nodes. 36 Ultimately, a patient is staged as a whole, rather than just a single site. Computed tomography will continue to play an important role in staging of local disease and pulmonary metastasis, but, given the limitations identified in this study, alternative methods must be considered for lymph node staging.…”

Predicting the Proliferation of Tongue Cancer With Artificial Intelligence in Contrast-Enhanced CT

“…However, compared to MRI, CT has advantages of lower price, shorter inspection times, and less contraindications, especially for patients with dental artifacts (33). In some studies, CECT outperforms MRI in detecting neck metastasis and assessment of tumor depth of invasion in oral cancer (34,35). Hence in TSCC, CECT is used more widely than MRI, which makes the research of CECT in TSCC more meaningful.…”

The Diagnostic Impact of Contrast-Enhanced Computed Tomography (CECT) in Evaluating Lymph Node Involvement in Colorectal Cancer: A Comprehensive Review

“…CECT and magnetic resonance imaging (MRI) are prominent imaging modalities for assessing lymph node involvement across various cancers. Numerous studies have sought to compare the diagnostic accuracy of these techniques [ 36 ]. For instance, a study by Chen et al focusing on nasopharyngeal carcinoma (NPC) revealed that MRI outperformed CECT in detecting retropharyngeal lymph node (RLN) metastases.…”