Role of contrast enhanced computed tomography in assessing cervical lymph node metastases in oral cavity squamous cell carcinoma

Author(s):  
Talha Ahmed Qureshi ◽  
Muhammad Wasif ◽  
Muhammad Sohail Awan ◽  
Adnan yar Muhammad ◽  
Ainulakbar Mughal ◽  
...  

Abstract Objectives: To evaluate the diagnostic accuracy of contrast enhanced CT scan to detect cervical nodal metastasis in oral cavity squamous cell carcinoma keeping final histopathology as gold standard. Methods: Cross sectional study conducted from 1st January 2015 - 31st October 2016. All patients undergoing surgery who had their CT scans done at our centre were included in the study. Diagnostic accuracy of CT scans was calculated using final histopathology as gold standard. All CT scan were reviewed by consultant radiologist. Results: Total 100 patients were reviewed, 70% were female, 55% had buccal and 32% had tongue cancer. 11 cases of T1, 20 cases of T2 , 4 cases of T3 and 21 cases of T4 stages were staged similarly by CT scan and histopathology, the kappa value of38.8%, p value <0.01. 6 cases of N1, 1 case of N2a , 9 cases of N2b, 3 cases of N2c, 1 case of N3 and 29 cases of N0 stages were staged similarly by CT scan and histopathology, with kappa value of 28.1%, p value of  <0.01. Sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy were 83%,61%,70.9%,76.3% and 73% respectively. Conclusion: CT scan is useful for preoperative staging of oral cavity squamous cell carcinoma with an overall diagnostic accuracy of 73%, currently there are no superior diagnostic modalities. However, Due to low specificity and negative predictive value elective neck dissection should still be done in a negative CT scan for cervical lymph node metastases. Keywords: Oral Cavity,

Author(s):  
Ahmed S. Abdelrahman ◽  
Manar Maamoun Mohamed Ashour ◽  
Tougan Taha Abdelaziz

Abstract Background The neck imaging reporting and data system (NI-RADS) is a structured reporting algorithm linked with further patient management recommendations. This study was conducted to assess the overall and time point predictive value of the NI-RADS in laryngeal and oral cavity squamous cell carcinoma (SCC) using contrast-enhanced magnetic resonance imaging (CEMRI) and contrast-enhanced computed tomography (CECT). Results The rate of tumor recurrence was statistically different among the NI-RADS 1-3 categories with recurrence trend for higher NI-RADS scores. The overall negative predictive value (NPV) of the NI-RADS 1 and 2 were 94.3%, 74.3% respectively, and the positive predictive value (PPV) of the NI-RADS 3 was 80.8%. The overall recurrence rate of NI-RADS 3 was higher in oral cavity SCC (87.5%) compared to the laryngeal SCC (70%). The PPV of overall NI-RADS 3 in the follow-up scans (77.8%) was higher than in the first scan (70.6%). The odd ratio of tumor recurrence in NI-RADS 3 primary lesion was 19.6. Conclusion The predictive value of NI-RADS was significantly different among its categories. Increasing NI-RADS score is associated with increased recurrence among the treated laryngeal and oral cavity SCC. The morphological and enhancement lexicon features equally assign the NI-RADS 3 score.


2021 ◽  
Vol 15 (8) ◽  
pp. 2500-2501
Author(s):  
Aliya Khan ◽  
Abid Ali Sahito ◽  
Mahreen Shaikh ◽  
Humera Jabeen ◽  
Humaira Ashraf ◽  
...  

Objective: To evaluate the diagnostic accuracy of multislice computed tomography (CT) in detection of squamous cell carcinoma (SCC) of oral cavity in clinically suspected patients taking histopathology as gold standard. Material and Methods: This cross-sectional study has been conducted at Radiology department of Civil Hospital Karachi from 8th September 2018 to March 2019. All the cases having suspected oral squamous cell carcinoma and either of gender were included. Patients underwent computed tomography by using multislice scanner. Then patients undergone biopsy sampling and patients were labeled as positive or negative for squamous cell carcinoma of oral cavity on MDCT and histopathology. Sensitivity, specificity, and diagnostic accuracy of multislice CT for squamous cell carcinoma of oral cavity were measured taking histopathology as gold standard. Results: Total 168 cases were studied and out of them males were 76.8% and females were 23.2%. Mean gutka addiction history was 11.52±5.21 years. Mean lesion size on CT scan was 2.44±1.43 cm. In our study, 35.1% patients were diagnosed positive by multislice computed tomography and 43.5% through histopathology. Sensitivity, Specificity, PPV, NPV and accuracy were 86.4%, 79.8%, 69.9%, 91.6%, and 82.1% respectively. Conclusion: Multislice CT observed to be the effective diagnostic tool for the detection of SCC of oral cavity. Keywords: Multislice Computed Tomography, cancer, Oral Cavity


2020 ◽  
Author(s):  
Na Guo ◽  
Weike Zeng ◽  
Hong Deng ◽  
Huijun Hu ◽  
Ziliang Cheng ◽  
...  

Abstract Background: To investigate whether quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters can be used to predict the pathologic stages of oral tongue squamous cell carcinoma (OTSCC). Methods: For this prospective study, DCE-MRI was performed in participants with OTSCC from May 2016 to June 2017. The pharmacokinetic parameters, including K trans , K ep , V e , and V p , were derived from DCE-MRI by utilizing a two-compartment extended Tofts model and a three-dimensional volume of interest. The postoperative pathologic stage was determined in each patient based on the 8th AJCC cancer staging manual. The quantitative DCE-MRI parameters were compared between stage I-II and stage III-IV lesions. Logistic regression analysis was used to determine independent predictors of tumor stages, followed by receiver operating characteristic (ROC) analysis to evaluate the predictive performance. Results: The mean K trans , K ep and V p values were significantly lower in stage III-IV lesions compared with stage I-II lesions ( p = 0.013, 0.005 and 0.011, respectively). K ep was an independent predictor for the advanced stages as determined by univariate and multivariate logistic analysis. ROC analysis showed that K ep had the highest predictive capability, with a sensitivity of 64.3%, a specificity of 82.6%, a positive predictive value of 81.8%, a negative predictive value of 65.5%, and an accuracy of 72.5%. Conclusion: The quantitative DCE-MRI parameter K ep can be used as a biomarker for predicting pathologic stages of OTSCC.


Cancer ◽  
2009 ◽  
Vol 115 (7) ◽  
pp. 1489-1497 ◽  
Author(s):  
Shao Hui Huang ◽  
David Hwang ◽  
Gina Lockwood ◽  
David P. Goldstein ◽  
Brian O'Sullivan

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Na Guo ◽  
Weike Zeng ◽  
Hong Deng ◽  
Huijun Hu ◽  
Ziliang Cheng ◽  
...  

Abstract Background To investigate whether quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters can be used to predict the pathologic stages of oral tongue squamous cell carcinoma (OTSCC). Methods For this prospective study, DCE-MRI was performed in participants with OTSCC from May 2016 to June 2017. The pharmacokinetic parameters, including Ktrans, Kep, Ve, and Vp, were derived from DCE-MRI by utilizing a two-compartment extended Tofts model and a three-dimensional volume of interest. The postoperative pathologic stage was determined in each patient based on the 8th AJCC cancer staging manual. The quantitative DCE-MRI parameters were compared between stage I–II and stage III–IV lesions. Logistic regression analysis was used to determine independent predictors of tumor stages, followed by receiver operating characteristic (ROC) analysis to evaluate the predictive performance. Results The mean Ktrans, Kep and Vp values were significantly lower in stage III–IV lesions compared with stage I–II lesions (p = 0.013, 0.005 and 0.011, respectively). Kep was an independent predictor for the advanced stages as determined by univariate and multivariate logistic analysis. ROC analysis showed that Kep had the highest predictive capability, with a sensitivity of 64.3%, a specificity of 82.6%, a positive predictive value of 81.8%, a negative predictive value of 65.5%, and an accuracy of 72.5%. Conclusion The quantitative DCE-MRI parameter Kep can be used as a biomarker for predicting pathologic stages of OTSCC.


2018 ◽  
Vol 160 (2) ◽  
pp. 277-283 ◽  
Author(s):  
Maxime Mermod ◽  
Massimo Bongiovanni ◽  
Tatiana Petrova ◽  
Elena Goun ◽  
Christian Simon ◽  
...  

Objective The management of occult lymph node metastasis (LNM) in head and neck squamous cell carcinoma has been a matter of controversy for decades. The vascular density within the tumor microenvironment, as an indicator of ongoing angiogenesis, could constitute an attractive predictor of LNM. The use of the panvascular endothelial antibody CD31 as a marker of occult LNM has never been reported. The aim of this study was to assess the predictive value of CD31 microvascular density for the detection of occult LNM in squamous cell carcinoma of the oral cavity and oropharynx. Study Design Case series with chart review. Setting Tertiary university hospital. Subjects and Methods Intra- and peritumoral microvascular density values were determined in 56 cases of squamous cell carcinoma of the oral cavity (n = 50) and oropharynx (n = 6) with clinically negative necks using the CD31 marker. Statistical associations of CD31 microvascular densities with clinicopathologic data were then established. Results Peritumoral CD31 microvascular density was significantly associated with occult LNM in multivariate analysis ( P < .01). Recursive partitioning analysis for this parameter found a cutoff of 19.33, which identified occult LNM with a sensitivity of 91%, a specificity of 65%, a positive predictive value of 40%, a negative predictive value of 97%, and an overall diagnostic accuracy of 71%. Conclusion Peritumoral CD31 microvascular density in primary squamous cell carcinoma of the oral cavity and oropharynx allows accurate prediction of occult LNM.


Author(s):  
Isnandar Isnandar ◽  
Harmas Yazid Yusuf ◽  
Bethy S. Hernowo

Oral cancer account for 30% of all malignant tumors in the head and neck, more than 90% of these cancers are squamous cell carcinoma. The p53 tumor suppressor gene known as "the guardian of the genome" has a major function in cell cycle control and act as a main defense against cancer, the occurrence of genomic instability causes inactivation and mutation of p53, which related to the progression of cancer cells and poor prognosis for patients. Human telomerase reverse transcriptase (hTERT), a catalytic protein subunit of the complex telomerase enzyme, prevents telomere erosion during DNA replication, thus allowing cells to escape the aging cell step. The relationship between hTERT and malignant transformation is around 90%, the detection of hTERT is associated with malignancy that leads to a worse prognosis which increases immortality or continuous growth in cancer cells. This study was conducted with retrospective cross sectional using immunohistochemical p53 and hTERT smear in 30 paraffin blocks of squamous cell carcinoma of the oral cavity, held at the Anatomical Pathology Department of Hasan Sadikin Hospital Bandung. P53 and hTERT immunoexpression were correlated with histopathological grading of squamous cell carcinoma of oral cavity (SCC) and statistically analyzed with Rank Spearman correlation with significance of p<0.05 (95%) and Kendall Coefficient of Concordance with significance of p <0.05% (95%). The results showed a significant positive correlation between p53 immunoexpression with histopathological grading (rs=0.497, p-value = 0.005), between hTERT immunoexpression and histopathological grading (rs=0.441, p-value=0.015), and between p53 and immunoexpression hTERT with histopathological grading (W=0.568, p-value=3.99E-08) Conclusion: the higher p53 and/or hTERT immunoexpression, the higher or worse the level of histopathological grading of oral cavity squamous cell carcinoma (poorly differentiated).


2020 ◽  
Author(s):  
Na Guo ◽  
Weike Zeng ◽  
Hong Deng ◽  
Huijun Hu ◽  
Ziliang Cheng ◽  
...  

Abstract Background: To investigate whether quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters can be used to predict the pathologic stages of oral tongue squamous cell carcinoma (OTSCC). Methods: For this prospective study, DCE-MRI was performed in participants with OTSCC from May 2016 to June 2017. The pharmacokinetic parameters, including K trans , K ep , V e , and V p , were derived from DCE-MRI by utilizing a two-compartment extended Tofts model and a three-dimensional volume of interest. The postoperative pathologic stage was determined in each patient based on the 8th AJCC cancer staging manual. The quantitative DCE-MRI parameters were compared between stage I-II and stage III-IV lesions. Logistic regression analysis was used to determine independent predictors of tumor stages, followed by receiver operating characteristic (ROC) analysis to evaluate the predictive performance. Results: The mean K trans , K ep and V p values were significantly lower in stage III-IV lesions compared with stage I-II lesions ( p = 0.013, 0.005 and 0.011, respectively). K ep was an independent predictor for the advanced stages as determined by univariate and multivariate logistic analysis. ROC analysis showed that K ep had the highest predictive capability, with a sensitivity of 64.3%, a specificity of 82.6%, a positive predictive value of 81.8%, a negative predictive value of 65.5%, and an accuracy of 72.5%. Conclusion: The quantitative DCE-MRI parameter K ep can be used as a biomarker for predicting pathologic stages of OTSCC.


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