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Nieberler M, Stimmer H, Rasthofer D, Nentwig K, Weirich G, Wolff KD. Defining secure surgical bone margins in head and neck squamous cell carcinomas: The diagnostic impact of intraoperative cytological assessment of bone resection margins compared with preoperative imaging. Oral Oncol 2020; 102:104579. [PMID: 32062159 DOI: 10.1016/j.oraloncology.2020.104579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 01/09/2020] [Accepted: 01/20/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Imaging provides crucial staging information for treatment planning of head and neck squamous cell carcinomas (HNSCCs). Despite technical progress in imaging techniques, defining the extent of bone involvement preoperatively remains challenging and requires intraoperative information to control for adequate resection. The intraoperative cytological assessment of the bone resection margins (ICAB) provides information whether bone is infiltrated by carcinoma. The aim of this study was to assess the diagnostic value of preoperative imaging compared with ICAB in order to achieve carcinoma-free bone margins. MATERIALS AND METHODS 108 HNSCC patients underwent preoperative computed tomography (CT), magnetic resonance imaging (MRI) and orthopantomogram (OPG) for staging and surgical planning. Curative resection was planned based on imaging. Intraoperatively, the resection margins were controlled by ICAB. The diagnostic value of preoperative imaging and ICAB was assessed with reference to the histological findings. RESULTS CT showed a sensitivity of 89.7%, specificity of 63.0%, positive predictive value (PPV) of 85.9%, and negative predictive value (NPV) of 70.8%. MRI revealed a sensitivity of 45.5%, specificity of 66.7%, PPV of 71.4% and NPV of 40.0%. OPG-imaging had a sensitivity of 64.7%, specificity of 76.2%, PPV of 81.5%, NPV 57.1%. In comparison, ICAB provided a sensitivity of 78.6%, specificity of 95.7%, PPV 73.3%, and NPV 96.7%. The accuracy was 82.1%, 52.9%, 69.0%, and 93.5% for CT, MRI, OPG, and ICAB, respectively. CONCLUSION Preoperative imaging lacks accuracy in defining adequate bone resection margins, compared with ICAB. ICAB supports preoperative imaging and intraoperative frozen sections to improve bone margin control.
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Affiliation(s)
- Markus Nieberler
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany.
| | - Herbert Stimmer
- Department of Radiology, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| | - Daniela Rasthofer
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| | - Katharina Nentwig
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| | - Gregor Weirich
- Institute of Pathology, Technische Universität München, Trogerstr. 18, 81675 Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
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Gao A, Teng Y, Seyiti P, Yen Y, Qian H, Xie C, Li R, Lin Z. Using Omniscan-Loaded Nanoparticles as a Tumor-Targeted MRI Contrast Agent in Oral Squamous Cell Carcinoma by Gelatinase-Stimuli Strategy. NANOSCALE RESEARCH LETTERS 2019; 14:395. [PMID: 31889247 PMCID: PMC6937353 DOI: 10.1186/s11671-019-3214-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 11/20/2019] [Indexed: 06/10/2023]
Abstract
In this study, the tumor-targeted MRI contrast agent was prepared with gelatinase-stimuli nanoparticles (NPs) and Omniscan (Omn) by double emulsion method. The size, distribution, morphology, stability, drug loading, and encapsulation efficiency of Omn-NPs were characterized. The macroscopic and microscopic morphological changes of NPs in response to gelatinases (collagenases IV) were observed. The MR imaging using Omn-NPs as a contrast agent was evaluated in the oral squamous cell carcinoma models with Omn as a control. We found clear evidence that the Omn-NPs were transformed by gelatinases and the signal of T1-weighted MRI sequence showed that the tumor-to-background ratio was significantly higher in Omn-NPs than in Omn. The peak point of time after injection was much later for Omn-NPs than Omn. This study demonstrates that Omn-NPs hold great promise as MRI contrast agent with improved specificity and prolonged circulation time based on a relatively simple and universal strategy.
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Affiliation(s)
- Antian Gao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 22 Hankou Road, Nanjing, 210093, China
| | - Yuehui Teng
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Pakezhati Seyiti
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 22 Hankou Road, Nanjing, 210093, China
| | - Yingtzu Yen
- The Comprehensive Cancer Center of Drum-Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, 321 Zhongshan Road, Nanjing, 210093, China
| | - Hanqing Qian
- The Comprehensive Cancer Center of Drum-Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, 321 Zhongshan Road, Nanjing, 210093, China
| | - Chen Xie
- Key Laboratory for Organic Electronics and Information Displays & Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Jiangsu National Synergetic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing, 210023, China
| | - Rutian Li
- The Comprehensive Cancer Center of Drum-Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, 321 Zhongshan Road, Nanjing, 210093, China.
| | - Zitong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China.
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Keshavarzi M, Darijani M, Momeni F, Moradi P, Ebrahimnejad H, Masoudifar A, Mirzaei H. Molecular Imaging and Oral Cancer Diagnosis and Therapy. J Cell Biochem 2017; 118:3055-3060. [PMID: 28390191 DOI: 10.1002/jcb.26042] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 04/06/2017] [Indexed: 12/31/2022]
Abstract
Oral cancer is known as one of relatively common type of cancer worldwide. Despite the easy access of the oral cavity to examination, oral tumors are diagnosed in more advanced stages of the disease. Imaging techniques have been recently emerged as non-invasive approaches to detect molecular and cellular changes in living cells and organisms. These techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) could help physicians to screen patients with oral tumors particularly oral squamous cell carcinoma (OSCC) in early stage of the disease. In this review, we discuss that early detection and diagnosis of oral tumors through using more robust and precise imaging techniques and a variety of cellular/molecular biomarkers not only could lead to more effective and less aggressive form of treatment for the disease but also could improve survival rates and lower treatment costs. J. Cell. Biochem. 118: 3055-3060, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Maryam Keshavarzi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mansoreh Darijani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Momeni
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pouya Moradi
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Ebrahimnejad
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Aria Masoudifar
- Department of Molecular Biotechnology, Royan Institute for Biotechnology, Cell Science Research Center, ACECR, Isfahan, Iran
| | - Hamed Mirzaei
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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[Imaging for surgical planning : Tumor surgery including reconstructive procedures]. HNO 2017; 65:472-481. [PMID: 28353078 DOI: 10.1007/s00106-017-0343-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Alongside clinical investigation, imaging is an important diagnostic modality for guiding treatment decisions and particularly for surgical planning in head and neck cancer. The significance and type of imaging depends on localization of the primary tumor. Beside the primary tumor, each imaging procedure must also include the lymph nodes, in order to develop an overall concept of surgical treatment. In addition to the superficial growth of a tumor, it is of utmost importance that its infiltration also be detected by imaging, in order to define the extent of tumor resection and identify potentially necessary reconstructive procedures. The type of imaging needed to understand tumor localization and size, e.g., CT or MRI, depends on the region. In some cases the methods are complementary.
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Sarrión Pérez MG, Bagán JV, Jiménez Y, Margaix M, Marzal C. Utility of imaging techniques in the diagnosis of oral cancer. J Craniomaxillofac Surg 2015; 43:1880-94. [DOI: 10.1016/j.jcms.2015.07.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/05/2015] [Accepted: 07/30/2015] [Indexed: 02/07/2023] Open
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Sun J, Li B, Li CJ, Li Y, Su F, Gao QH, Wu FL, Yu T, Wu L, Li LJ. Computed tomography versus magnetic resonance imaging for diagnosing cervical lymph node metastasis of head and neck cancer: a systematic review and meta-analysis. Onco Targets Ther 2015; 8:1291-313. [PMID: 26089682 PMCID: PMC4467645 DOI: 10.2147/ott.s73924] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Computed tomography (CT) and magnetic resonance imaging (MRI) are common imaging methods to detect cervical lymph node metastasis of head and neck cancer. We aimed to assess the diagnostic efficacy of CT and MRI in detecting cervical lymph node metastasis, and to establish unified diagnostic criteria via systematic review and meta-analysis. A systematic literature search in five databases until January 2014 was carried out. All retrieved studies were reviewed and eligible studies were qualitatively summarized. Besides pooling the sensitivity (SEN) and specificity (SPE) data of CT and MRI, summary receiver operating characteristic curves were generated. A total of 63 studies including 3,029 participants were involved. The pooled results of meta-analysis showed that CT had a higher SEN (0.77 [95% confidence interval {CI} 0.73–0.87]) than MRI (0.72 [95% CI 0.70–0.74]) when node was considered as unit of analysis (P<0.05); MRI had a higher SPE (0.81 [95% CI 0.80–0.82]) than CT (0.72 [95% CI 0.69–0.74]) when neck level was considered as unit of analysis (P<0.05) and MRI had a higher area under concentration-time curve than CT when the patient was considered as unit of analysis (P<0.05). With regards to diagnostic criteria, for MRI, the results showed that the minimal axial diameter of 10 mm could be considered as the best size criterion, compared to 12 mm for CT. Overall, MRI conferred significantly higher SPE while CT demonstrated higher SEN. The diagnostic criteria for MRI and CT on size of metastatic lymph nodes were suggested as 10 and 12 mm, respectively.
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Affiliation(s)
- J Sun
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
| | - B Li
- West China School of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
| | - C J Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
| | - Y Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
| | - F Su
- Department of stomatology, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Q H Gao
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - F L Wu
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - T Yu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China
| | - L Wu
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - L J Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
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