Advertisement

Diagnostic efficacy of combined CT and MRI in detecting nodal metastasis in patients with oral cancer

Published:September 23, 2021DOI:https://doi.org/10.1016/j.oooo.2021.09.003

      Objective

      The objective of this study was to assess the diagnostic efficacy of combined computed tomography (CT) and magnetic resonance imaging (MRI) in detecting metastases of oral cancers to lymph nodes in the neck.

      Study Design

      In total, 105 patients with previously untreated oral squamous cell carcinoma underwent both CT and MRI within 6 weeks before tumor excision and selective neck dissection. The diagnostic efficacy of combined CT and MRI was compared with published data on the efficacy of CT and MRI alone.

      Results

      The sensitivity, specificity, positive and negative predictive values, and accuracy of diagnosis based on CT and MRI were 80%, 90%, 80%, 90%, and 87%, respectively. These values were similar to or higher than those reported in a meta-analysis for CT or MRI alone. The highest and lowest sensitivities were found for metastatic nodes at levels I (75%) and III (33%). The highest and lowest specificities were discovered for nodes at levels IV (99%) and I (88%).

      Conclusions

      Combined CT and MRI may be superior to a single modality alone in detecting metastatic neck nodes. This may have an advantage in both preoperative planning and neck surveillance in superficial oral cancers.
      To read this article in full you will need to make a payment

      References

      1. International Agency for Research on Cancer. Cancer today. Available at: http://gco.iarc.fr/today/home. Accessed August 1, 2020.

        • Cerezo L
        • Millán I
        • Torre A
        • Aragón G
        • Otero J
        Prognostic factors for survival and tumor control in cervical lymph node metastases from head and neck cancer. A multivariate study of 492 cases.
        Cancer. 1992; 69: 1224-1234
        • Johnson JT
        • Barnes EL
        • Myers EN
        • Schramm VL
        • Borochovitz D
        • Sigler BA.
        The extracapsular spread of tumors in cervical node metastasis.
        Arch Otolaryngol Chic Ill 1960. 1981; 107: 725-729
        • Liao L-J
        • Hsu W-L
        • Wang C-T
        • Lo W-C
        • Lai M-S.
        Analysis of sentinel node biopsy combined with other diagnostic tools in staging cN0 head and neck cancer: a diagnostic meta-analysis.
        Head Neck. 2016; 38: 628-634
        • Som PM
        • Curtin HD
        • Mancuso AA.
        Imaging-based nodal classification for evaluation of neck metastatic adenopathy.
        Am J Roentgenol. 2000; 174: 837-844
        • Jalisi S.
        Management of the clinically negative neck in early squamous cell carcinoma of the oral cavity.
        Otolaryngol Clin North Am. 2005; 38 (viii): 37-46
        • Ren Z-H
        • Xu J-L
        • Li B
        • Fan T-F
        • Ji T
        • Zhang C-P
        Elective versus therapeutic neck dissection in node-negative oral cancer: evidence from five randomized controlled trials.
        Oral Oncol. 2015; 51: 976-981
        • D'Cruz AK
        • Vaish R
        • Kapre N
        • et al.
        Elective versus therapeutic neck dissection in node-negative oral cancer.
        N Engl J Med. 2015; 373: 521-529
        • Friedman M
        • Shelton VK
        • Mafee M
        • Bellity P
        • Grybauskas V
        • Skolnik E.
        Metastatic neck disease. Evaluation by computed tomography.
        Arch Otolaryngol Chic Ill 1960. 1984; 110: 443-447
        • Close LG
        • Merkel M
        • Vuitch MF
        • Reisch J
        • Schaefer SD.
        Computed tomographic evaluation of regional lymph node involvement in cancer of the oral cavity and oropharynx.
        Head Neck. 1989; 11: 309-317
        • Hutchison IL
        • Ridout F
        • Cheung SMY
        • et al.
        Nationwide randomised trial evaluating elective neck dissection for early stage oral cancer (SEND study) with meta-analysis and concurrent real-world cohort.
        Br J Cancer. 2019; 121: 827-836
        • Kim JH
        • Choi KY
        • Lee S-H
        • et al.
        The value of CT, MRI, and PET-CT in detecting retropharyngeal lymph node metastasis of head and neck squamous cell carcinoma.
        BMC Med Imaging. 2020; 20: 88
        • Chen J
        • Hagiwara M
        • Givi B
        • et al.
        Assessment of metastatic lymph nodes in head and neck squamous cell carcinomas using simultaneous 18 F-FDG-PET and MRI.
        Sci Rep. 2020; 10: 20764
        • Liao L-J
        • Lo W-C
        • Hsu W-L
        • Wang C-T
        • Lai M-S.
        Detection of cervical lymph node metastasis in head and neck cancer patients with clinically N0 neck—a meta-analysis comparing different imaging modalities.
        BMC Cancer. 2012; 12: 236
        • Chaukar D
        • Dandekar M
        • Kane S
        • et al.
        Relative value of ultrasound, computed tomography and positron emission tomography imaging in the clinically node-negative neck in oral cancer.
        Asia Pac J Clin Oncol. 2016; 12: e332-e338
        • Pantvaidya GH
        • Pal P
        • Vaidya AD
        • Pai PS
        • D'Cruz AK
        Prospective study of 583 neck dissections in oral cancers: implications for clinical practice: cervical lymph nodal mapping in 583 neck dissections.
        Head Neck. 2014; 36: 1503-1507