Lam Paul, Au-Yeung Kai Ming, Cheng Pui Wai, Wei William Ignace, Yuen Anthony Po-Wing, Trendell-Smith Nigel, Li Jimmy H C, Li Raymond
Division of Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, The University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong ROC.
AJR Am J Roentgenol. 2004 Mar;182(3):803-8. doi: 10.2214/ajr.182.3.1820803.
Tumor thickness in oral tongue cancer is an important independent prognostic factor for local recurrence, nodal metastasis, and patient survival. An accurate preoperative assessment of tumor thickness is therefore essential for optimal treatment planning. The aim of our study was to evaluate the accuracy of MRI findings for the preoperative measurement of tumor thickness. SUBJECTS AND METHODS. Eighteen patients with oral tongue cancer underwent preoperative MRI of the tongue. After surgery, the glossectomy specimens were serially sectioned. The radiologic tumor thickness of contrast-enhanced T1-weighted and T2-weighted images was compared with the histologic tumor thickness using our proposed tumor thickness staging classifications. These included stage I (tumor < or = 3 mm), stage II (> 3 mm but < or = 9 mm) and stage III (> 9 mm).
The overall accuracy in assessment of proposed tumor thickness staging using contrast-enhanced T1-weighted and T2-weighted images was 83% and 56%, respectively. The radiologic tumor thickness as measured on contrast-enhanced T1-weighted and T2-weighted images had significant correlation with histologic tumor thickness (R = 0.938 and 0.941, respectively).
MR images provide satisfactory accuracy for the measurement of tumor thickness and staging of oral tongue cancer. Preoperative MRI is recommended to assist in treatment planning for patients with this disease.
口腔舌癌的肿瘤厚度是局部复发、淋巴结转移及患者生存的重要独立预后因素。因此,准确的术前肿瘤厚度评估对于优化治疗方案至关重要。本研究旨在评估MRI检查结果在术前测量肿瘤厚度方面的准确性。
18例口腔舌癌患者术前行舌部MRI检查。术后,对舌切除标本进行连续切片。利用我们提出的肿瘤厚度分期分类方法,将对比增强T1加权和T2加权图像上的放射学肿瘤厚度与组织学肿瘤厚度进行比较。这些分类包括I期(肿瘤≤3mm)、II期(>3mm但≤9mm)和III期(>9mm)。
使用对比增强T1加权和T2加权图像评估所提出的肿瘤厚度分期的总体准确率分别为83%和56%。对比增强T1加权和T2加权图像上测量的放射学肿瘤厚度与组织学肿瘤厚度具有显著相关性(分别为R = 0.938和0.941)。
MR图像在测量口腔舌癌肿瘤厚度及分期方面具有令人满意的准确性。建议术前行MRI检查以辅助制定该病患者的治疗方案。