Heidkamp Jan, Weijs Willem L J, van Engen-van Grunsven Adriana C H, de Laak-de Vries Ilse, Maas Marnix C, Rovers Maroeska M, Fütterer Jurgen J, Steens Stefan C A, Takes Robert P
Department of Radiology and Nuclear Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
Head Neck. 2020 Aug;42(8):2039-2049. doi: 10.1002/hed.26125. Epub 2020 Mar 2.
Current intraoperative methods of visual inspection and tissue palpation by the surgeon, and frozen section analysis cannot reliably prevent inadequate surgical margins in patients treated for oral squamous-cell carcinoma (OSCC). This study assessed feasibility of MRI for the assessment of surgical resection margins in fresh OSCC specimens.
Ten consecutive tongue specimens containing OSCC were scanned using 3 T clinical whole-body MRI. Two radiologists independently annotated OSCC location and minimal tumor-free margins. Whole-mount histology was the reference standard.
The positive predictive values (PPV) and negative predictive values (NPV) for OSCC localization were 96% and 75%, and 87% and 79% for reader 1 and 2, respectively. The PPV and NPV for identification of margins <5 mm were 38% and 91%, and 5% and 87% for reader 1 and 2, respectively.
MRI accurately localized OSCC with high inter-reader agreement in fresh OSCC specimens, but it seemed not yet feasible to accurately assess the surgical margin status.
目前外科医生术中的视觉检查、组织触诊以及冰冻切片分析等方法，无法可靠地预防口腔鳞状细胞癌（OSCC）患者手术切缘不足的情况。本研究评估了MRI在新鲜OSCC标本中评估手术切缘的可行性。
使用3T临床全身MRI对连续的10个含有OSCC的舌标本进行扫描。两名放射科医生独立标注OSCC的位置和最小无瘤切缘。全层组织学检查为参考标准。
对于OSCC定位，读者1和读者2的阳性预测值（PPV）分别为96%和87%，阴性预测值（NPV）分别为75%和79%。对于识别<5mm切缘，读者1和读者2的PPV分别为38%和5%，NPV分别为91%和87%。
MRI能在新鲜OSCC标本中准确地定位OSCC，且读者间一致性较高，但准确评估手术切缘状态似乎尚不可行。
