Techniques, Tricks, and Stratagems of Oral Cavity Computed Tomography and Magnetic Resonance Imaging

Maraghelli, Davide; Pietragalla, Michele; Calistri, Linda; Barbato, Luigi; Locatello, Luca Giovanni; Orlandi, Martina; Landini, Nicholas; Casto, Antonio Lo; Nardi, Cosimo

doi:10.3390/app12031473

Cited by 17 publications

(9 citation statements)

References 58 publications

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“…The authors found that positron emission tomography/CT showed higher sensitivity, specificity, positive predictive value, and negative predictive value than did the two other modalities, making it an important diagnostic tool in the preoperative staging of squamous cell carcinoma of the oral cavity. According to Maraghelli et al ( 35 ) , multislice CT and MRI are fundamental and complementary in the study and observation of oral infiltration by cavitary diseases, whereas ultrasound and cone-beam CT still play only a marginal role. They also concluded that although positron-emission tomography with fluorine-18-fluorodeoxyglucose does not allow a morphological evaluation like multislice CT and MRI, it is useful in detecting oral neoplasms that are undetectable on conventional imaging, lymph node metastases, other distant metastases, and post-radiotherapy recurrence.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography evaluation of alterations in the masticator space due to invasion by malignant head and neck neoplasms

Campinhos,

Curioni,

Soares

et al. 2023

Radiol Bras

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Objective: To evaluate alterations in the masticator space due to the dissemination of malignant neoplasms originating from the tonsillar fossa, retromolar trigone, maxillary sinus, or nasopharynx, using computed tomography (CT), as well as to correlate the presence of trismus with the CT findings and the dimensions of the tumor. Materials and Methods: We evaluated the medical records of 65 patients with malignant tumors in the regions described. The images were analyzed by two physician examiners, working independently, who were blinded to the clinical data. In the evaluation of the masticator space, the following parameters were considered: symmetry with the contralateral space; obliteration of the fat plane, retromolar trigone, or pharyngeal space; edema/atrophy of the medial or lateral pterygoid muscles; and destruction of the mandibular ramus. Results: Obliteration of the fat plane was found in 69.2% of the patients. Asymmetry, edema/atrophy, and bone destruction were detected in 27.7%, 26.2%, and 20.0% of the patients, respectively. Trismus was identified in 15.4% of the patients. Of the patients with trismus, 90.0% had stage T4 tumors, compared with only 43.8% of those without trismus. Trismus was 11.6 times more common among the patients with stage T4 tumors than among those with lower-stage tumors. Neoplasms of the tonsillar fossa and retromolar trigone collectively accounted for 95.0% of the cases. The CT scans showed edema/atrophy of the pterygoid muscles in 60.0% of the patients with trismus and in 21.8% of those without. An association was observed between T4 tumor stage and edema/atrophy of the pterygoid muscles. In addition, the risk of trismus was 5.4 times higher among the patients with stage T4 tumors. Conclusion: In our patient sample, the most common finding was obliteration of the fat plane, followed by asymmetry and edema/atrophy. Most of the patients with T4 tumors had trismus, together with edema/atrophy of the pterygoid muscles.

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Section: Discussionmentioning

confidence: 99%

Computed tomography evaluation of alterations in the masticator space due to invasion by malignant head and neck neoplasms

Campinhos,

Curioni,

Soares

et al. 2023

Radiol Bras

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“…Puffed cheek technique improves the contour and margin delineation as compared to the conventional CECT. 23 Also, this technique separates the mucosal surface from alveolus enabling better assessment of subtle lesions that may otherwise be missed in routine imaging. With puffed cheek technique structures like buccal mucosa, gingival, buccal vestibule and RMT are better delineated ( Fig.…”

Section: Imaging Guidelinesmentioning

confidence: 99%

Imaging Recommendations for Diagnosis, Staging, and Management of Oral Cancer

Mahajan

Agarwal

et al. 2023

Indian J Med Paediatr Oncol

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Oral cavity cancers contribute to a majority of cancers in India. Clinical examination alone cannot determine the deeper extent of the disease; therefore, need for cross-sectional imaging including computed tomography and magnetic resonance imaging becomes indispensable for pre-treatment evaluation to decide optimal plan of management. Oral cavity squamous cell cancers (OSCC) can be treated with surgery alone, whereas deep muscle, neurovascular, osseous, or nodal involvement on imaging suggests advanced disease that requires a combination of surgery, radiation, and/or chemotherapy. Because of the complex anatomy of the oral cavity and its surrounding structures, imaging is crucial for locoregional staging and early detection of distant metastases. Imaging plays indispensable role not only in diagnosis but also in planning the management. An optimal guideline paper for developing countries like India is lacking that not only helps standardize the management but will also assist oncologists make reasonable decisions and reduce the unnecessary imaging. This imaging guideline paper will discuss the optimal imaging in diagnosis and management OSCC for Indian subcontinent.

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“…DCE-PWI is crucial in the detection of focal lesions since it mainly assesses the vascular permeability [23]. Changes in hemodynamic parameters can precede abnormalities on conventional MRI and can thus be used to help with the diagnosis [22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer

et al. 2023

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The aim of this single-center, observational, retrospective study was to investigate magnetic resonance imaging (MRI) biomarkers for the assessment of radiotherapy (RT)-induced xerostomia. Twenty-seven patients who underwent radiation therapy for oropharyngeal cancer were divided into three groups according to the severity of their xerostomia—mild, moderate, and severe—clinically confirmed with the Common Terminology Criteria for Adverse Events (CTCAE). No severe xerostomia was found. Conventional and functional MRI (perfusion- and diffusion- weighted imaging) performed both pre- and post-RT were studied for signal intensity, mean apparent diffusion coefficient (ADC) values, k-trans, and area under the perfusion curves. Contrast-enhanced T1 images and ADC maps were imported into 3D slicer software, and salivary gland volumes were segmented. A total of 107 texture features were derived. T-Student and Wilcoxon signed-rank tests were performed on functional MRI parameters and texture analysis features to identify the differences between pre- and post-RT populations. A p-value < 0.01 was defined as acceptable. Receiver operating characteristic (ROC) curves were plotted for significant parameters to discriminate the severity of xerostomia in the pre-RT population. Conventional and functional MRI did not yield statistically significant results; on the contrary, five texture features showed significant variation between pre- and post-RT on the ADC maps, of which only informational measure of correlation 1 (IMC 1) was able to discriminate the severity of RT-induced xerostomia in the pre-RT population (area under the curve (AUC) > 0.7). Values lower than the cut-off of −1.473 × 10−11 were associated with moderate xerostomia, enabling the differentiation of mild xerostomia from moderate xerostomia with a 73% sensitivity, 75% specificity, and 75% diagnostic accuracy. Therefore, the texture feature IMC 1 on the ADC maps allowed the distinction between different degrees of severity of RT-induced xerostomia in the pre-RT population. Accordingly, texture analysis on ADC maps should be considered a useful tool to evaluate salivary gland radiosensitivity and help identify patients at risk of developing more serious xerostomia before radiation therapy is administered.

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Techniques, Tricks, and Stratagems of Oral Cavity Computed Tomography and Magnetic Resonance Imaging

Cited by 17 publications

References 58 publications

Computed tomography evaluation of alterations in the masticator space due to invasion by malignant head and neck neoplasms

Computed tomography evaluation of alterations in the masticator space due to invasion by malignant head and neck neoplasms

Imaging Recommendations for Diagnosis, Staging, and Management of Oral Cancer

Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer

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