Nuclear Medicine Department, Molecular Imaging Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Oral Oncol. 2011 Apr;47(4):288-95. doi: 10.1016/j.oraloncology.2011.02.010.
Our aim was to retrospectively assess the diagnostic performance from combined positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) for the detection of bone marrow invasion of the mandible or maxilla in patients with oral cavity squamous cell carcinoma (OCSCC). A total of 114 patients with OCSCC, arising from or abutting the upper or lower alveolar ridge, underwent staging PET/CT and MRI studies before surgery. The possibility of bone marrow invasion on PET/CT and MRI was graded retrospectively on a 5-point score. Histopathology was taken as the reference standard. Sensitivity, specificity, predictive values and likelihood ratios were calculated. Clinical factors affecting the performance, like tumor origin and dentate status were also explored. PET/CT was found to be more specific than MRI (83% vs. 61%, respectively, p=0.0015) but less sensitive (78% vs. 97%, respectively, p=0.0391). Dentate status and tumor origin affected the diagnostic performance of PET/CT. In patients with positive MRI, sensitivity and specificity of PET/CT were 78% and 100% in dentate patients with alveolar ridge tumors, 75% and 80% in dentate patient with buccal tumors, 90% and 33% in edentulous patients with alveolar ridge tumors and 0% and 63% for edentulous patients with buccal tumors, respectively. PET/CT is more specific than MRI and can be used to complement the role of MRI. A negative MRI result can confidently exclude the presence of bone marrow invasion, while in patients with positive MRI findings, a negative PET/CT may be useful to rule out bone marrow invasion in dentate patients.
我们的目的是回顾性评估正电子发射断层扫描/计算机断层扫描（PET/CT）和磁共振成像（MRI）联合检测口腔鳞状细胞癌（OCSCC）患者下颌或上颌骨髓侵犯的诊断性能。共有 114 名 OCSCC 患者，源自或毗邻上下牙槽嵴，在手术前进行分期 PET/CT 和 MRI 研究。PET/CT 和 MRI 上骨髓侵犯的可能性通过 5 分制评分进行回顾性分级。组织病理学作为参考标准。计算了敏感性、特异性、预测值和似然比。还探讨了影响性能的临床因素，如肿瘤起源和有牙状态。与 MRI 相比，PET/CT 的特异性更高（分别为 83%和 61%，p=0.0015），但敏感性更低（分别为 78%和 97%，p=0.0391）。有牙状态和肿瘤起源影响了 PET/CT 的诊断性能。在 MRI 阳性的患者中，牙槽嵴肿瘤有牙患者的 PET/CT 敏感性和特异性分别为 78%和 100%，颊部肿瘤有牙患者为 75%和 80%，牙槽嵴肿瘤无牙患者为 90%和 33%，颊部肿瘤无牙患者为 0%和 63%。与 MRI 相比，PET/CT 更具特异性，可用于补充 MRI 的作用。阴性 MRI 结果可明确排除骨髓侵犯的存在，而在 MRI 阳性的患者中，阴性 PET/CT 可能有助于排除有牙患者的骨髓侵犯。
