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Ravikanth R. MR evaluation of tongue carcinoma in the assessment of depth of invasion with histopathological correlation: A single center experience. Indian J Radiol Imaging 2020; 30:126-138. [PMID: 33100679 PMCID: PMC7546288 DOI: 10.4103/ijri.ijri_286_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/08/2019] [Accepted: 04/10/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Magnetic resonance imaging (MRI) has become the cornerstone for pretreatment evaluation of carcinoma tongue and provides accurate information regarding the extent of the lesion and depth of invasion that helps the clinician to optimize treatment strategy. Aim of the study is to correlate MRI and histopathological findings, to evaluate the role of MRI in loco-regional tumor node metastasis (TNM) staging, and to assess the depth of invasion of tongue carcinoma. Materials and Methods This study was undertaken on 30 patients with clinical diagnosis of tongue carcinoma referred for MR imaging at a tertiary care hospital over the 2-year period between July 2017 and June 2019. MRI was performed with GE 1.5 Tesla scanner, neurovascular (NV) array coil. Clinical and MRI staging of tongue carcinoma was done preoperatively and correlated. Post-surgery, histopathological TNM staging was done and correlated with clinical and MRI TNM staging. The cutoff value of histopathological (HP) depth that could determine the existence of nodal metastasis was 5 mm. Results In 30 patients diagnosed with tongue carcinoma, the incidence was higher in males (92%). Moderate agreement (k = 0.512) was noted for T staging between clinical and MRI staging assessments. Fair agreement (k = 0.218) was noted for N stage between clinical and MRI staging assessments. There was good agreement (k = 0.871) for M stage between the clinical and MRI staging assessments. Good agreement (k = 0.822 and k = 0.767, respectively) was noted for both T staging and Nstaging between MRI and histopathology staging assessments. The agreement for the T stage was poor (k = 0.012) between the clinical and histopathology staging assessments. Agreement for the N stage was also poor (k = 0.091) between the clinical and histopathology staging assessments. Mean depth of invasion by histology and MRI was 14.22 mm and 16.12 mm, respectively. Moderate agreement (k = 0.541) was noted between clinical and pathological tumor depth and good agreement (k = 0.844) was noted between radiological and pathological tumor depth. As for the T1WGd MRI depth with a cutoff value of 5 mm, the nodal metastasis rate in the group with values >5 mm was 52%, and for those <5 mm was 24%, both of which were significantly different (P = 0.040). Pearson's correlation coefficient of HP depth and T1WGd MRI depth was 0.851 (P < 0.001) suggesting that HP depth shows a strong correlation with T1WGd MRI depth. Conclusion MRI is the imaging modality of choice for evaluation of tongue carcinoma as MRI helps in accurate staging of the tumor using TNM classification which is crucial for optimizing treatment options. The current study shows a high correlation between MRI and histopathological findings regarding thickness of tumor and depth of invasion. MRI and histopathology assessments of tumor spread were equivalent to within 0.5 mm DOI. Estimation of invasion depth using MRI as a preoperative study in oral tongue carcinoma is essential in planning surgical treatment strategies such as the extent of elective neck dissection. Invasion depth, which greatly affects occult node metastases, must be included in the TNM staging of oral tongue carcinoma.
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Affiliation(s)
- Reddy Ravikanth
- Department of Radiology, Holy Family Hospital, Thodupuzha, Kerala, India
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Magnetic resonance imaging based radiomics signature for the preoperative discrimination of stage I-II and III-IV head and neck squamous cell carcinoma. Eur J Radiol 2018; 106:1-6. [PMID: 30150029 DOI: 10.1016/j.ejrad.2018.07.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/08/2018] [Accepted: 07/02/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE This study aimed to investigate the predictive ability of magnetic resonance imaging (MRI) based radiomics signature for the preoperative staging in HNSCC. METHODS This study involved127 consecutive patients (training cohort: n = 85; testing cohort, n = 42) with stage I-IV HNSCC. A total of 970 radiomics features were extracted from T2-weighted (T2W) (n = 485) and contrast-enhanced T1-weighted (ceT1W) (n = 485) MRI for each case. Radiomics signatures were constructed with least absolute shrinkage and selection operator (LASSO) logistic regression. Associations between radiomics signatures and HNSCC staging were explored. Areas under the receiver operating characteristic curve (AUC) and classification performance of radiomics signatures were determined and compared with those of the visual assessment. RESULTS Ten features from T2W images, six from ceT1W images, and six from combined T2W and ceT1W images were selected by LASSO logistic regression. The three radiomics signatures of stage III-IV HNSCC were significantly higher than that for stage I-II in both cohorts (all P < 0.05). The radiomics signatures from ceT1W and combined images performed well in the discrimination of stage I-II and III-IV HNSCC, with AUCs of 0.828 and 0.850 in the training cohort, and AUCs of 0.853 and 0.849 in the testing cohort. Based on the cut-off value of the training cohort, the radiomics signature from combined images achieved best classification performance in both cohorts, with accuracies of 0.788 and 0.857, sensitivities of 0.836 and 0.885, and specificities of 0.700 and 0.813. Significant differences in accuracy and sensitivity were found between the radiomics signature from combined images and the visual assessment of the radiologists in the training cohort. CONCLUSION Radiomics signature based on MRI could discriminate stage I-II from stage III-IV HNSCC, which may serve as a complementary tool for preoperative staging.
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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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Singh A, Thukral CL, Gupta K, Sood AS, Singla H, Singh K. Role of MRI in Evaluation of Malignant Lesions of Tongue and Oral Cavity. Pol J Radiol 2017; 82:92-99. [PMID: 28289481 PMCID: PMC5325040 DOI: 10.12659/pjr.899352] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 06/13/2016] [Indexed: 02/01/2023] Open
Abstract
Background Aim of the present study was to evaluate the role of MRI in staging of malignant lesions of the oral cavity and to correlate MRI findings with clinical/surgical and anatomical-pathological findings, wherever possible. Material/Methods The study included 50 patients who presented with malignant lesions of the oral cavity and were referred to radiology departments for MRI. All patients included were subjected to a detailed physical examination following which MRI was carried out on Philips Gyroscan Achieva 1.5 Tesla unit. Results In the study, the highest number of patients were found to have tongue malignancy (82%) followed by buccal mucosa and gingivobuccal sulcus malignancy (18%). The highest number of patients was in the age group of 51–60 years (32%). The incidence was higher in males (96%). There was moderate agreement (k=0.537) for T stage between the clinical and MRI staging assessments. The agreement for N stage between clinical and MRI staging assessments was fair (k=0.328). The final diagnosis was made by histopathology in 22 patients. The agreement for T stage was good/substantial (k=0.790) and for N stage was moderate (k=0.458) between MRI and histopathology staging assessments. Conclusions MRI provides satisfactory accuracy for preoperative estimation of tumor thickness and predicting occult cervical nodal metastasis. MRI is the preferred modality in evaluation and staging of oral cavity malignancy which helps a clinician for planning of treatment.
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Affiliation(s)
- Amandeep Singh
- Department of Radiodiagnosis and Imaging, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Chuni Lal Thukral
- Department of Radiodiagnosis and Imaging, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Kamlesh Gupta
- Department of Radiodiagnosis and Imaging, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Arvinder Singh Sood
- Department of Otorhinolaryngology (ENT), Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Hanish Singla
- Department of Radiodiagnosis, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
| | - Kunwarpal Singh
- Department of Radiodiagnosis, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India
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Goel V, Parihar PS, Parihar A, Goel AK, Waghwani K, Gupta R, Bhutekar U. Accuracy of MRI in Prediction of Tumour Thickness and Nodal Stage in Oral Tongue and Gingivobuccal Cancer With Clinical Correlation and Staging. J Clin Diagn Res 2016; 10:TC01-5. [PMID: 27504375 DOI: 10.7860/jcdr/2016/17411.7905] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 02/18/2016] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Squamous cell carcinoma of lower gingivo-buccal complex and tongue are the most common cancer in the Indian sub-continent. The value of imaging in the staging of Oral Squamous Cell Carcinoma (OSCC) is in judging operability, assessment of the prognostic characteristics and dimensions of the primary tumour, depth of tumour invasion, the presence of cervical metastasis and detection of bone infiltration. AIM This study evaluated squamous cell carcinomas of the oral cavity (tongue and gingivo-buccal complex) on the basis of their appearance, soft tissue extent, depth of tumour invasion and staging. Further, this study assessed the accuracy of MRI in the detection of cervical lymph nodal metastasis on the basis of ADC values on diffusion weighted MR sequence. MATERIALS AND METHODS T1- and T2-weighted MR, diffusion-weighted sequences and post contrast T1W sequences were performed in various planes on biopsy proven squamous cell carcinomas (61 cases) involving tongue and/or gingivo-buccal region. Depth of tumour invasion was calculated on axial images of post contrast T1W images. The Apparent Diffusion Coefficient (ADC) was measured by using two b factors (500 and 1000 s/mm(2)). MRI findings were compared clinically and histopathologically. RESULTS Average depth of invasion calculated on MRI was 8.47mm and by histopathology was 6.85mm. Pearson's correlation coefficient was 0.988. Shrinkage factor was 0.8. A 71% of patients with depth of invasion greater than 9mm showed evidence of cervical lymph nodal metastasis at one or another levels. Cut-off value to discriminate between malignant and benign lymph nodes was 1.038 x10-3 mm(2)/s in the present study. CONCLUSION Depth of tumour invasion in oral malignancies can be measured reliably on MRI which helps in predicting cervical lymph node metastasis. Benign or malignant cervical lymph nodes can be differentiated on diffusion-weighted imaging of MRI on the basis of their ADC values.
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Affiliation(s)
- Varun Goel
- Post Graduate Student, Datta Meghe Institute of Medical Science , Maharashtra, India
| | - Pratap Singh Parihar
- Associate Professor, Department of Radio-Diagnosis, Datta Meghe Institute of Medical Science , Maharashtra, India
| | - Akhilesh Parihar
- Intern, Datta Meghe Institute of Medical Science , Maharashtra, India
| | - Ashok Kumar Goel
- Radiologist, Datta Meghe Institute of Medical Science , Maharashtra, India
| | - Kapil Waghwani
- Lecturer, Department of Oral and Maxillofacial Surgery, Datta Meghe Institute of Medical Science, Sharad Pawar Dental College , Wardha, Maharashtra, India
| | - Richa Gupta
- Consultant, Department of Oral and Maxillofacial Surgery, Jabalpur Hospital , Madhya Pradesh, India
| | - Umesh Bhutekar
- Lecturer, Department of Oral and Maxillofacial Surgery, Datta Meghe Institute of Medical Science, Sharad Pawar Dental College , Wardha, Maharashtra, India
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de Moura PM, Hallac RR, Seaward JR, Kane AA, Aguiar M, Raggio R, Gutfilen B. Objective and subjective image evaluation of maxillary alveolar bone based on cone beam computed tomography exposure parameters. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:557-65. [PMID: 27068313 DOI: 10.1016/j.oooo.2016.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 12/15/2015] [Accepted: 01/23/2016] [Indexed: 01/10/2023]
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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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Hamanaka EF, Poi WR, Salzedas LMP, Alves LC, Panzarini SR, Sonoda CK, Martins CM. A method for the geometric standardization of intraoral radiographs for long-term follow up of replanted teeth: a case report. Dent Traumatol 2012; 29:121-6. [DOI: 10.1111/j.1600-9657.2012.01145.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Elizane Ferreira Hamanaka
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Wilson Roberto Poi
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Leda Maria Pescinini Salzedas
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Lucieni Campoli Alves
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Sônia Regina Panzarini
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Celso Koogi Sonoda
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
| | - Christine Men Martins
- Department of Surgery and Integrated Clinics; School of Dentistry of Araçatuba, São Paulo State University (UNESP); Araçatuba; SP; Brazil
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