Baba Akira, Ojiri Hiroya, Ogane Satoru, Hashimoto Kazuhiko, Inoue Takashi, Takagiwa Mutsumi, Goto Tazuko K
Department of Radiology, The Jikei University School of Medicine and University Hospital, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 1058461, Japan.
Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa-shi, Chiba, 272-8513, Japan.
Oral Radiol. 2021 Jan;37(1):86-94. doi: 10.1007/s11282-020-00429-y. Epub 2020 Feb 21.
There is currently no standardized approach for assessing the depth of invasion (DOI) of oral tongue squamous cell carcinoma via diagnostic imaging. We investigated the usefulness of contrast-enhanced computed tomography (CECT) for estimating the pathological DOI of oral tongue squamous cell carcinoma by evaluating the correlation of pathological DOI with the DOIs on CECT and magnetic resonance imaging (MRI).
We retrospectively reviewed 21 of 139 patients who underwent radical surgery for primary oral tongue squamous cell carcinoma between 2009 and 2018. The 21 cases were evaluable, without dental artifacts on CECT. DOIs on CECT and MRI, and pathological DOI were measured.
The median pathological DOI was 9 mm, that on CECT was 10.9 mm, that on T2-weighted MRI was 14.2 mm, and that on contrast-enhanced T1-weighted MRI was 13.1 mm. The DOIs on CECT and on MRI were larger than the pathological DOI (p = 0.003 to < 0.001). The absolute value of the difference between pathological DOI and DOI on CECT was smaller than that between pathological DOI and DOI on MRI (p = 0.01 and 0.003). DOIs on CECT and on MRI correlated with pathological DOI (r = 0.74-0.66, all p < 0.001). Spearman's correlation coefficient between DOI on CECT and pathological DOI was greater than that between DOI on MRI and pathological DOI.
Compared to the DOI determined on an MRI scan, the DOI determined on a CECT scan correlated with and better approximated pathological DOI. Therefore, CECT can be useful for preoperative staging of patients with oral tongue squamous cell carcinoma.
目前尚无通过诊断性影像学评估口腔舌鳞状细胞癌浸润深度（DOI）的标准化方法。我们通过评估病理DOI与CT增强扫描（CECT）及磁共振成像（MRI）上的DOI之间的相关性，研究CECT在估计口腔舌鳞状细胞癌病理DOI方面的实用性。
我们回顾性分析了2009年至2018年间139例行原发性口腔舌鳞状细胞癌根治性手术患者中的21例。这21例患者可评估，CECT上无牙齿伪影。测量了CECT和MRI上的DOI以及病理DOI。
病理DOI的中位数为9mm，CECT上为10.9mm，T2加权MRI上为14.2mm，增强T1加权MRI上为13.1mm。CECT和MRI上的DOI大于病理DOI（p = 0.003至<0.001）。病理DOI与CECT上的DOI之间差值的绝对值小于病理DOI与MRI上的DOI之间差值的绝对值（p = 0.01和0.003）。CECT和MRI上的DOI与病理DOI相关（r = 0.74 - 0.66，均p < 0.001）。CECT上的DOI与病理DOI之间的Spearman相关系数大于MRI上的DOI与病理DOI之间的相关系数。
与MRI扫描确定的DOI相比，CECT扫描确定的DOI与病理DOI相关且更接近病理DOI。因此，CECT可用于口腔舌鳞状细胞癌患者的术前分期。
