用于评估口腔癌骨侵犯的高分辨率锥形束计算机断层扫描：与传统计算机断层扫描的比较。
High-resolution cone-beam computed tomography for assessment of bone invasion in oral cancer: Comparison with conventional computed tomography.
作者信息
Czerwonka Lukasz, Bissada Eric, Goldstein David P, Wood Robert E, Lam Ernest W, Yu Eugene, Lazinski Dorothy, Irish Jonathan C
机构信息
Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, Stony Brook University, Stony Brook, New York.
Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
出版信息
Head Neck. 2017 Oct;39(10):2016-2020. doi: 10.1002/hed.24858. Epub 2017 Jul 12.
BACKGROUND
Radiologic assessment of mandibular bone invasion is critical in evaluating the extent of bone resection required in patients with oral cancer. There are a few reports of improved sensitivity with cone-beam CT (CBCT) over conventional CT.
METHODS
A prospective cohort study of patients with oral squamous cell carcinomas adjacent to the mandible requiring marginal or segmental mandibular resection was performed. Patients were treated based on clinical assessment and conventional cross-sectional imaging. Patients and surgeons were blinded to the results of CBCT performed preoperatively. Pathologic examination served as the gold standard.
RESULTS
Forty-five patients were included in the study. Thirty-three percent of the patients underwent segmental mandibulectomy and 37% had bone invasion. The sensitivity and specificity of CBCT were 91% and 60%, respectively, compared to 86% and 68% for CT with bone windows.
CONCLUSION
A CBCT offers marginally improved sensitivity at the cost of reduced specificity for assessment of bone invasion compared to CT.
背景
下颌骨侵犯的影像学评估对于评估口腔癌患者所需的骨切除范围至关重要。有一些报告指出，锥形束CT（CBCT）相较于传统CT，敏感性有所提高。
方法
对需要进行下颌骨边缘或节段性切除的下颌骨旁口腔鳞状细胞癌患者进行了一项前瞻性队列研究。患者根据临床评估和传统横断面成像进行治疗。患者和外科医生对术前进行的CBCT结果不知情。病理检查作为金标准。
结果
45例患者纳入研究。33%的患者接受了下颌骨节段切除术，37%的患者有骨侵犯。CBCT的敏感性和特异性分别为91%和60%，而骨窗CT的敏感性和特异性分别为86%和68%。
结论
与CT相比，CBCT在评估骨侵犯时敏感性略有提高，但特异性降低。
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