Oropharynx, oral cavity, floor of the mouth: CT and MRI

Lenz, Martin; Greeß, H.; Baum, Ulrich; Dobritz, Martin; Kersting-Sommerhoff, B

doi:10.1016/s0720-048x(99)00143-6

Cited by 88 publications

(55 citation statements)

References 15 publications

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“…[12][13][14]19 In the preoperative treatment of oral cancer, it has been shown that MRI is better for evaluating soft tissue, bone marrow involvement and perineural invasion, and has been particularly decisive in the diagnosis of small lesions. 7,20,21 The discrepancies found in the comparisons between the staging established by clinical and MRI examinations demonstrate the importance of this study. A clinical staging assessment lower than the real staging could result in ineffective treatment and/ or increase the possibility of recurrence in a particular case, whereas a higher clinical staging assessment could lead to more radical treatment, thereby increasing treatment aftereffects.…”

Section: Discussionmentioning

confidence: 88%

Oral cancer staging established by magnetic resonance imaging

et al. 2011

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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.

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Section: Discussionmentioning

confidence: 88%

Oral cancer staging established by magnetic resonance imaging

et al. 2011

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“…Based on CECT studies, sometimes it may be difficult to differentiate between tumour and inflammation or oedema, which usually leads to upstaging of the malignant process [6,8,16]. For better evaluation of the extent of malignant tissue, a new tool of functional imaging has been introduced -CT perfusion.…”

Section: Discussionmentioning

confidence: 99%

“…The following issues were addressed during evaluation of CECT multi-planar images: space from which the tumour originated, possible infiltration of surrounding structures and staging according to International Union Against Cancer (UICC) guidelines. Signs of malignant infiltration were evaluated as previously described in the literature [14][15][16][17].…”

Section: Data Analysis and Reference Standardmentioning

confidence: 99%

Head and neck squamous cell cancer – the role of computed tomography enhanced with perfusion imaging in tumour staging

Trojanowska¹,

Trojanowski²,

Drop³

et al. 2011

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A Ai im m o of f t th he e s st tu ud dy y: : To determine the added value of computed tomography perfusion (CTP) images combined with contrast-enhanced computed tomography (CECT) images in staging of head and neck squamous cell cancer (SCC). M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : Forty-seven consecutive patients with histologically proven squamous cell cancer of the head and neck and qualified for surgical treatment were prospectively evaluated in 2 groups: based on CECT multiplanar reformations (axial, coronal and sagittal), and separately, based on CTP images combined with CECT data. Tumour stage was assessed in each group separately, with special emphasis on T4 stage, and results were compared with histological findings. Five patients underwent endoscopic laser tumour resection, 11 underwent other tumour resection (glossectomy, pharyngectomy) and 31 patients underwent en-bloc resection of the hypopharynx and larynx, allowing detailed pathological evaluation of possible tumour infiltration into surrounding structures. Two experienced head and neck radiologists evaluated the images.Inter-observer agreement was tested with the modified κ test. The χ 2 test was applied to compare the number of correctly staged tumours for the two methods and readers. R Re es su ul lt ts s: : Inter-observer agreement was high (k = 0.88-0.90). Significant differences between the two groups were observed; with added CTP assessment more anatomical structures were rated positive for tumour infiltration and diagnostic accuracy of this method was significantly higher when compared to CECT images. Sole evaluation of CECT images in less advanced cases led to overestimation of the disease, since inflammation and slight oedema could not be differentiated from tumour. C Co on nc cl lu us si io on ns s: : Contrast-enhanced computed tomography multi-planar images enhanced with CTP images were proven to improve accuracy in head and neck cancer staging. The added value of CTP may help to avoid overestimation of the malignant process and at the same time may facilitate depiction all infiltrated structures.K Ke ey y w wo or rd ds s: : CT perfusion, squamous cell cancer, TNM, computed tomography.

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“…It is an non-invasive scanning method and it provides excellent tissue contrast. 31 In a study comparing the MRI features of different cysts of oral and maxillofacial region. Hisatomi et al, found out that NPDCs have high signal intensity on T1-weighted images (T1WI) whereas most cystic lesions in the maxillofacial region have low to intermediate signal intensity on T1WI.…”

Section: 4513mentioning

confidence: 99%