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

Background Diagnosis of maxillary sinus pathology must include the clinical radiological study (CRS) and histopathological analysis. The aim of this study is 1) to describe the clinicopathological features of maxillary sinus lesions, obtained successively in a single medical centre over the last 10 years and 2) to determine the sensitivity and specificity for the diagnosis of malignant lesions based exclusively on the CRS. Methods It is a single-centre observational retrospective clinical study on patients who attended the University Hospital Complex of Santiago de Compostela (CHUS) with sinus pathologies during the period of 2009–2019. Results The sample consisted of 133 men (62.1%) and 81 women (37.9%), with an average age of 46.9 years (SD = 18.8). In terms of frequency, the most frequent pathology was the unspecified sinusitis (44.4%), followed by polyps (18.2%), malignant tumours (9.8%), inverting papilloma (7.5%), fungal sinusitis (4.7%), cysts (3.7%), benign tumours (2.3%), mucocele (2.3%) and other lesions (1.9%). Cysts and benign tumours were diagnosed earliest Vs malignant tumours (65.2 years (SD = 16.1)) were diagnosed the latest (p < 0.001). Based only on the CRS for malignancies, diagnostic indexes were 71.4% sensitivity and 97.9% specificity, with a Kappa value of 0.68 with (p < 0.001). Conclusion Maxillary sinus pathology is very varied with therapeutic and prognostic repercussions. CRS is sometimes insufficient and histopathological confirmation is essential.

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“…In terms of using CBCT or CT for diagnostic accuracy, we did not find any difference. This matter has been confirmed by other authors [6].…”

Section: Discussionsupporting

confidence: 87%

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

et al. 2020

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“…In 2017, Czerwonka and colleagues compared CBCT with conventional CT and reported that the sensitivity and specificity values for CBCT were 91% and 60%, respectively, whereas those for CT with bone windows were 86% and 68%, respectively. 8 These reports provide a basis for the use of CBCT in evaluations of tumor bone invasion. In our study, CBCT predicted bone invasion with 100% accuracy, a higher level than those reported in other studies.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of cone-beam computed tomography for the evaluation of mandible invasion by oral squamous cell carcinoma

Zhang

Wang

et al. 2020

Preprint

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Purpose: Surgery for oral cancer with mandibular invasion requires an accurate preoperative assessment. Although cone-beam computed tomography (CBCT), which yields high spatial resolution, is used widely for mandibular examinations, evidence supporting its accuracy for the evaluation of malignant mandibular invasion is insufficient. Therefore, this study aimed to explore the accuracy of CBCT for the preoperative assessment of mandibular invasion.Methods: Thirty mandibular specimens acquired via mandibulectomy for oral squamous cell carcinoma (OSCC) treatment were collected. The excised samples were marked and subjected to CBCT imaging. Hematoxylin–eosin staining was used for histopathological assessment. Mandibular invasion was estimated based on CBCT and pathologic findings. Invasive borders were delineated via histopathological examination and CBCT and merged to compare the extent of invasion.Results: Although CBCT predicted the excised mandible invasion with 100% accuracy, it predicted nerve invasion with only 69.2% accuracy. The bone samples exhibited significant shrinkage (8.9%) due to tissue processing. This bone mass shrinkage led to a tendency of CBCT to underestimate the extent of invasion, with a mean difference of 2.97 mm.Conclusion: CBCT can reliably assess mandibular invasion, but is much less accurate for the estimation of nerve invasion. Given the potential for underestimation of the extent of mandibular invasion, CBCT would be better used to determine the extent of osteotomy.

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“…In a previous report, compared to histological results, the bone invasion presented on panoramic radiograph was smaller with 13mm in width and 2 mm in depth; and was smaller with 5 mm in width and larger with 3 mm in depth on spiral CT. A systematic review compared several modalities in detecting mandibular invasion by OSCC, the results showed that the sensitivity of bone invasion diagnosis for magnetic resonance imaging, CBCT, spiral CT and panoramic radiography was 94%, 91%, 83%, and 55% and the speci city was 100%, 100%, 97% and 91.7% for magnetic resonance imaging, CBCT, positron emission tomography/CT and panoramic radiography respectively [7]. Czerwonka et al compared the diagnosis e ciency of CBCT with conventional spiral CT, they found that the sensitivity and speci city were 91% and 60% for CBCT and were 86% and 68% for spiral CT [8].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of cone-beam computed tomography for the evaluation of mandible invasion by oral squamous cell carcinoma

Zhang

Wang

et al. 2020

Preprint

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Background: Accurate evaluation of mandible invasion and resection with appropriate boundary for oral squamous cell carcinoma (OSCC) are important for preserving structure and function of mandible and preventing local recurrence. Although cone-beam computed tomography (CBCT), which has high spatial resolution, is now widely used in the diagnosis of oral and maxillofacial bone lesions. There were no studies systematically evaluate the accuracy of CBCT for evaluation of presence of bone invasion, boundary of bone invasion and presence of nerve invasion. Therefore, this study aimed to systemically explore the accuracy of CBCT in preoperative assessment of mandibular invasion by OSCC. Methods: Thirty mandibular specimens from OSCC patients were collected in this study. The samples were marked and subjected to CBCT examination. Hematoxylin–eosin staining was used for histopathological assessment and used as golden standard. The evaluation included the presence of bone invasion, boundary of bone invasion and presence of nerve invasion. The CBCT and histopathological boundaries of bone invasion were delineated and merged to compare and calculate the deviation of CBCT in boundary evaluation. Results: The accuracy of CBCT in evaluation of presence of mandible invasion was 100%, and the accuracy of CBCT in evaluation of presence of nerve invasion was 69.2%. A mean deviation of 2.97 mm was found for assessment the boundary of bone invasion using CBCT compared with the histopathological standard. Conclusion: CBCT is quite reliable in determine the presence or absence of mandible invasion, while not so reliable for nerve invasion. The deviation in bone invasion boundary estimation should be considered in the osteotomy for OSCC.

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

Abstract: A CBCT offers marginally improved sensitivity at the cost of reduced specificity for assessment of bone invasion compared to CT.

Cited by 14 publications

References 10 publications

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

Accuracy of cone-beam computed tomography for the evaluation of mandible invasion by oral squamous cell carcinoma

Accuracy of cone-beam computed tomography for the evaluation of mandible invasion by oral squamous cell carcinoma

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