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Lam V, O'Brien O, Amin O, Nigar E, Kumar M, Lingam RK. Oral cavity cancer and its pre-treatment radiological evaluation: A pictorial overview. Eur J Radiol 2024; 176:111494. [PMID: 38776803 DOI: 10.1016/j.ejrad.2024.111494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Oral cavity cancer, primarily squamous cell carcinoma (SCC), is a prevalent malignancy globally, necessitating accurate clinical assessment and staging to enable effective treatment planning. Diagnosis requires biopsy and is followed by surgical resection and reconstruction as the primary therapeutic modality. Imaging plays a pivotal role during this process, aiding in the evaluation of tumour extent, nodal involvement and distant metastases. However, despite its value, both radiologists and clinicians must recognise its inherent limitations. METHODS This pictorial review article aims to illustrate the application of various imaging modalities in the pre-treatment evaluation of oral cavity SCC and highlights potential pitfalls. It underscores the importance of understanding the anatomical subsites of the oral cavity, the diverse patterns of spread tumours exhibit at each site, alongside the role of imaging in facilitating informed management strategies, while also acknowledging its limitations. RESULTS The review delves into fundamentals of current staging including nodal involvement, while, emphasising imaging strategies and potential limitations. Finally, it touches on the potential of novel radiomic techniques in characterising tumours and predicting treatment response. CONCLUSIONS Pre-treatment oral cavity cancer staging reflects an ongoing quest for enhanced diagnostic accuracy and prognostic prediction. Recognising the value of imaging alongside its limitations fosters a multidisciplinary approach to treatment planning, ultimately improving patient outcomes.
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Affiliation(s)
- Vincent Lam
- Department of Radiology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom
| | - Owen O'Brien
- Department of Radiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom
| | - Omed Amin
- Department of Radiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom; Department of Radiology, Chelsea and Westminster NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, United Kingdom
| | - Ezra Nigar
- Department of Pathology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom
| | - Mahesh Kumar
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom; Department of Oral and Maxillofacial Surgery, Hillingdon Hospital, The Hillingdon Hospitals NHS Foundation Trust, Pield Heath Rd, Uxbridge UB8 3NN, United Kingdom
| | - Ravi Kumar Lingam
- Department of Radiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom.
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Omami G, Yeoh M. Malignant Lesions of the Oral Region. Dent Clin North Am 2024; 68:319-335. [PMID: 38417993 DOI: 10.1016/j.cden.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article focuses on the radiographic presentations of various malignant conditions that affect the oral region and delineates the role of CT, MR imaging, and PET in oral cancer imaging.
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Affiliation(s)
- Galal Omami
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, 770 Rose Street, MN320, Lexington, KY 40536, USA.
| | - Melvyn Yeoh
- Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, 770 Rose Street, D-528, Lexington, KY 40536, USA
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Vermaire JA, Partoredjo ASK, de Groot RJ, Brand HS, Speksnijder CM. Mastication in health-related quality of life in patients treated for oral cancer: A systematic review. Eur J Cancer Care (Engl) 2022; 31:e13744. [PMID: 36239005 PMCID: PMC9787816 DOI: 10.1111/ecc.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 09/14/2022] [Accepted: 09/27/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Treatment for oral cancer can impair oral functions such as mastication, which may negatively affect quality of life (QoL). In this review, an overview is provided of masticatory ability in patients treated for oral cancer. METHODS The PubMed (MEDLINE), Embase and Cochrane databases were systematically searched for scientific literature on masticatory ability in relation to QoL in patients treated for oral cancer. Studies were included when oral cancer treatment was provided, and the University of Washington Quality of Life (UW-QoL) questionnaire was used. Risk of bias (MINORS) was independently assessed by two authors. RESULTS The PubMed (MEDLINE), Embase and Cochrane search yielded 575 unique records of which 111 were assessed full text, and 27 studies were included. The UW-QoL mastication scores ranged from 31.9 to 97.4. There was a wide variety in methodology, patient groups, tumour site, treatment and assessment moment, to such a degree that outcome scores are difficult to compare. CONCLUSION The wide variety in studies exploring health-related QoL in relation to mastication in oral cancer patients prevents the identification of possible relations between treatment, masticatory ability and QoL. Our findings underline the limitations in currently available literature and indicate the necessity for more comparable research.
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Affiliation(s)
- Jorine A. Vermaire
- Imaging Division, Department of Radiation Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Abbergayle S. K. Partoredjo
- Department of Oral and Maxillofacial Surgery and Special Dental Care, Department of Head and Neck Surgical Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands,Department of Oral BiochemistryAcademic Centre for Dentistry Amsterdam (ACTA)AmsterdamThe Netherlands
| | - Reilly J. de Groot
- Department of Oral and Maxillofacial Surgery and Special Dental Care, Department of Head and Neck Surgical Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Henk S. Brand
- Department of Oral BiochemistryAcademic Centre for Dentistry Amsterdam (ACTA)AmsterdamThe Netherlands
| | - Caroline M. Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care, Department of Head and Neck Surgical Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands,Department of Head and Neck Surgical Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
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Roig-Soriano X, Souto EB, Elmsmari F, Garcia ML, Espina M, Duran-Sindreu F, Sánchez-López E, González Sánchez JA. Nanoparticles in Endodontics Disinfection: State of the Art. Pharmaceutics 2022; 14:1519. [PMID: 35890414 PMCID: PMC9316632 DOI: 10.3390/pharmaceutics14071519] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 01/27/2023] Open
Abstract
Endodontic-related diseases constitute the fourth most expensive pathologies in industrialized countries. Specifically, endodontics is the part of dentistry focused on treating disorders of the dental pulp and its consequences. In order to treat these problems, especially endodontic infections, dental barriers and complex root canal anatomy should be overcome. This constitutes an unmet medical need since the rate of successful disinfection with the currently marketed drugs is around 85%. Therefore, nanoparticles constitute a suitable alternative in order to deliver active compounds effectively to the target site, increasing their therapeutic efficacy. Therefore, in the present review, an overview of dental anatomy and the barriers that should be overcome for effective disinfection will be summarized. In addition, the versatility of nanoparticles for drug delivery and their specific uses in dentistry are comprehensively discussed. Finally, the latest findings, potential applications and state of the art nanoparticles with special emphasis on biodegradable nanoparticles used for endodontic disinfection are also reviewed.
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Affiliation(s)
- Xavier Roig-Soriano
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
| | - Eliana B Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
- REQUIMTE/UCIBIO, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Firas Elmsmari
- Department of Clinical Sciences, College of Dentistry, Ajman University, University Street Al Jerf 1, Ajman 346, United Arab Emirates
- Center of Medical and Bio-Allied Health Sciences Research, Ajman University, University Street Al Jerf 1, Ajman 346, United Arab Emirates
| | - Maria Luisa Garcia
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
| | - Marta Espina
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
| | - Fernando Duran-Sindreu
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Elena Sánchez-López
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
- Unit of Synthesis and Biomedical Applications of Peptides, IQAC-CSIC, 08034 Barcelona, Spain
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Abstract
ABSTRACT Understanding oral cavity and oropharyngeal anatomy is important to identify various pathologies that may afflict them. This article reviews normal magnetic resonance imaging anatomy of these vital spaces and structures, with special attention to the complex musculature, mucosal surfaces, relevant osseous structures, salivary glands, and nerves. Anatomic awareness of these spaces and critical potential pathways for perineural tumoral spread are important to recognize to improve diagnostic evaluation and treatment.
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Al-Sabbagh M, Hawasli A, Kudsi R, Omami G, Epstein JB, Miller CS. Carcinoma mistaken for periodontal disease: importance of careful consideration of clinical and radiographic findings. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:e151-e156. [PMID: 33547019 DOI: 10.1016/j.oooo.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Mohanad Al-Sabbagh
- Division of Periodontics, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Ahmad Hawasli
- Woodbridge Periodontal and Implant Center, Woodbridge, VA, USA
| | - Rachad Kudsi
- Division of Periodontics, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Galal Omami
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, College of Dentistry, University of Kentucky.
| | - Joel B Epstein
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA; Cedars-Sinai Health System, Los Angeles, CA, USA
| | - Craig S Miller
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, College of Dentistry, University of Kentucky
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Omami G. Gingival Squamous Cell Carcinoma. EAR, NOSE & THROAT JOURNAL 2019; 99:NP46-NP47. [PMID: 30966786 DOI: 10.1177/0145561319838510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Galal Omami
- Division of Oral Medicine, Diagnosis and Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, Lexington, KY, USA
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Junn JC, Baugnon KL, Lacayo EA, Hudgins PA, Patel MR, Magliocca KR, Corey AS, El-Deiry M, Wadsworth JT, Beitler JJ, Saba NF, Liu Y, Aiken AH. CT Accuracy of Extrinsic Tongue Muscle Invasion in Oral Cavity Cancer. AJNR Am J Neuroradiol 2016; 38:364-370. [PMID: 28059707 DOI: 10.3174/ajnr.a4993] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/30/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Extrinsic tongue muscle invasion in oral cavity cancer upstages the primary tumor to a T4a. Despite this American Joint Committee on Cancer staging criterion, no studies have investigated the accuracy or prognostic importance of radiologic extrinsic tongue muscle invasion, the feasibility of standardizing extrinsic tongue muscle invasion reporting, or the degree of agreement across different disciplines: radiology, surgery, and pathology. The purpose of this study was to assess the agreement among radiology, surgery, and pathology for extrinsic tongue muscle invasion and to determine the imaging features most predictive of extrinsic tongue muscle invasion with surgical/pathologic confirmation. MATERIALS AND METHODS Thirty-three patients with untreated primary oral cavity cancer were included. Two head and neck radiologists, 3 otolaryngologists, and 1 pathologist prospectively evaluated extrinsic tongue muscle invasion. RESULTS Fourteen of 33 patients had radiologic extrinsic tongue muscle invasion; however, only 8 extrinsic tongue muscle invasions were confirmed intraoperatively. Pathologists were unable to determine extrinsic tongue muscle invasion in post-formalin-fixed samples. Radiologic extrinsic tongue muscle invasion had 100% sensitivity, 76% specificity, 57% positive predictive value, and 100% negative predictive value with concurrent surgical-pathologic evaluation of extrinsic tongue muscle invasion as the criterion standard. On further evaluation, the imaging characteristic most consistent with surgical-pathologic evaluation positive for extrinsic tongue muscle invasion was masslike enhancement. CONCLUSIONS Evaluation of extrinsic tongue muscle invasion is a subjective finding for all 3 disciplines. For radiology, masslike enhancement of extrinsic tongue muscle invasion most consistently corresponded to concurrent surgery/pathology evaluation positive for extrinsic tongue muscle invasion. Intraoperative surgical and pathologic evaluation should be encouraged to verify radiologic extrinsic tongue muscle invasion to minimize unnecessary upstaging. Because this process is not routine, imaging can add value by identifying those cases most suspicious for extrinsic tongue muscle invasion, thereby prompting this more detailed evaluation by surgeons and pathologists.
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Affiliation(s)
- J C Junn
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
| | - K L Baugnon
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
| | - E A Lacayo
- Department of Radiology (E.A.L.), Georgetown University, Washington, DC
| | - P A Hudgins
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
| | - M R Patel
- Otolaryngology (M.R.P., M.E.-D., J.T.W.)
| | | | - A S Corey
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
| | - M El-Deiry
- Otolaryngology (M.R.P., M.E.-D., J.T.W.)
| | | | | | | | - Y Liu
- Statistics (Y.L.), Emory University School of Medicine, Atlanta, Georgia
| | - A H Aiken
- From the Departments of Imaging Sciences (J.C.J., K.L.B., P.A.H., A.S.C., A.H.A.)
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Arya S, Rane P, Sable N, Juvekar S, Bal M, Chaukar D. Retromolar trigone squamous cell cancers: A reappraisal of 16 section MDCT for assessing mandibular invasion. Clin Radiol 2013; 68:e680-8. [DOI: 10.1016/j.crad.2013.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/21/2013] [Accepted: 08/06/2013] [Indexed: 11/30/2022]
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Hagiwara M, Nusbaum A, Schmidt BL. MR assessment of oral cavity carcinomas. Magn Reson Imaging Clin N Am 2012; 20:473-94. [PMID: 22877952 DOI: 10.1016/j.mric.2012.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Approximately half of head and neck carcinomas arise from the oral cavity. Imaging plays an essential role in the preoperative evaluation of oral cavity carcinomas. MR imaging is particularly advantageous in the evaluation of the oral cavity, with better depiction of the anatomy in this region and reduction of dental artifacts compared with CT. MR is also the preferred imaging modality for the evaluation of bone marrow invasion and perineural tumor spread, which are findings critical for treatment planning. Advanced MR imaging techniques may potentially better delineate true tumor extent, determine lymph node metastases, and predict treatment response.
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Affiliation(s)
- Mari Hagiwara
- Department of Radiology, NYU School of Medicine, 660 1st Avenue, 2nd floor Radiology, New York, NY 10016, USA.
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12
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Law CP, Chandra RV, Hoang JK, Phal PM. Imaging the oral cavity: key concepts for the radiologist. Br J Radiol 2011; 84:944-57. [PMID: 21933981 DOI: 10.1259/bjr/70520972] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The oral cavity is a challenging area for radiological diagnosis. Soft-tissue, glandular structures and osseous relations are in close proximity and a sound understanding of radiological anatomy and common pathways of disease spread is required. In this pictorial review we present the anatomical and pathological concepts of the oral cavity with emphasis on the complementary nature of diagnostic imaging modalities.
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Affiliation(s)
- C P Law
- Department of Radiology, Royal Melbourne Hospital, Parkville, Victoria, Australia
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13
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Abstract
Tumours in the oral cavity and oropharynx differ in presentation and prognosis and the detection of spread of tumour from one subsite to another is essential for the T-staging. This article reviews the anatomy and describes the pattern of spread of different cancers arising in the oral cavity and oropharynx; the imaging findings on computerized tomography and magnetic resonance imaging are also described. Brief mention is made on the role of newer imaging modalities such as [18F]fluorodeoxyglucose-positron emission tomography/computed tomography, perfusion studies and diffusion-weighted magnetic resonance imaging.
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Affiliation(s)
- Dechen Wangmo Tshering Vogel
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland.
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Baek CH, Chung MK, Son YI, Choi JY, Kim HJ, Yim YJ, Ko YH, Choi J, Cho JK, Jeong HS. Tumor volume assessment by 18F-FDG PET/CT in patients with oral cavity cancer with dental artifacts on CT or MR images. J Nucl Med 2008; 49:1422-8. [PMID: 18703597 DOI: 10.2967/jnumed.108.051649] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
UNLABELLED The purpose of this study was to investigate the clinical usefulness of PET/CT or CT-attenuated PET in the evaluation of patients with oral cavity cancer (OCC) in whom dental artifacts distorted the conventional CT or MR images of the oral cavity. METHODS A PET/CT scan, in addition to a CT or MRI scan, was performed in 69 patients with OCC who had dentures or dental implants. A total of 64 PET/CT, 64 CT, and 27 MR images were analyzed including images from scans performed on 40 patients with OCC without dental artifacts on the conventional images; these were used for comparison. The CT-attenuated PET scan for the detection of primary tumors was compared with the CT or MRI scan. We also evaluated the correlation between the PET/CT volume and the pathologic volume using a regression analysis. In addition, subgroup analysis was performed to determine what proportion of subjects benefited most from the PET/CT. RESULTS CT-attenuated PET detected more primary tumors than did CT in patients with OCC with dental artifacts (95.3% vs. 75.0%, respectively; P=0.0016). PET/CT volume with a standardized uptake value (SUV) cutoff point of 3.5 predicted the pathologic volume more accurately than did the other cutoff points in patients with OCC with or without artifacts. After comparing pathologic volume and PET/CT(SUV 3.5) volume, the following regression equation was developed: log (pathologic volume)=0.6 x log (PET/CT(SUV 3.5) volume) + 1.3 (R(2) = 0.42, P<0.0001). Subgroup analysis showed that the prediction of the pathologic volume from the PET/CT images was more reliable for tumors that were more than 2 cm in depth (R(2)=0.72). CONCLUSION For patients with OCC with dental artifacts on the conventional imaging, PET/CT could provide useful clinical information about the primary tumors, particularly in cases with advanced tumors.
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Affiliation(s)
- Chung-Hwan Baek
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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