Accuracy of cone-beam computed tomography for the evaluation of mandible invasion by oral squamous cell carcinoma
Abstract Background: Accurate evaluation of mandible invasion and resection with appropriate boundary for oral squamous cell carcinoma (OSCC) are important for preserving structure and function of mandible and preventing local recurrence. Although cone-beam computed tomography (CBCT), which has high spatial resolution, is now widely used in the diagnosis of oral and maxillofacial bone lesions. There were no studies systematically evaluate the accuracy of CBCT for evaluation of presence of bone invasion, boundary of bone invasion and presence of nerve invasion. Therefore, this study aimed to systemically explore the accuracy of CBCT in preoperative assessment of mandibular invasion by OSCC.Methods: Thirty mandibular specimens from OSCC patients were collected in this study. The samples were marked and subjected to CBCT examination. Hematoxylin–eosin staining was used for histopathological assessment and used as golden standard. The evaluation included the presence of bone invasion, boundary of bone invasion and presence of nerve invasion. The CBCT and histopathological boundaries of bone invasion were delineated and merged to compare and calculate the deviation of CBCT in boundary evaluation. Results: The accuracy of CBCT in evaluation of presence of mandible invasion was 100%, and the accuracy of CBCT in evaluation of presence of nerve invasion was 69.2%. A mean deviation of 2.97 mm was found for assessment the boundary of bone invasion using CBCT compared with the histopathological standard. The inter-examiner agreement and intra-examiner agreement were perfect for the detection of bone invasion and nerve invasion (κ>0.8). Intraclass Correlation Coefficient was 0.923 for the consistency test of boundary delineation on CBCT image.Conclusion: CBCT is quite reliable in determine the presence or absence of mandible invasion, while not so reliable for nerve invasion. The deviation in bone invasion boundary estimation should be considered in the osteotomy for OSCC.