Head and Neck Surgery, University Hospitals of Leicester, United Kingdom.
Head and Neck Surgery, University Hospitals of Leicester, United Kingdom.
Br J Oral Maxillofac Surg. 2021 Dec;59(10):1275-1279. doi: 10.1016/j.bjoms.2021.06.008. Epub 2021 Jun 24.
The recent eighth edition of the American Joint Committee on Cancer (AJCC) staging system has introduced depth of invasion (DOI) as one of its important components. DOI is also important for deciding neck management in superficial tongue cancers. Magnetic resonance imaging (MRI) is mainly used to assess DOI, and in this study we have evaluated the efficacy of MRI to detect it. This is a retrospective study consisting of 60 treatment-naïve tongue cancer patients operated on between July 2017 and June 2019. Patients underwent MR imaging on an Optima MR450W 1.5T unit, and MRI was reported by two experienced head and neck radiologists. Postoperative histological DOI was considered the gold standard. The correlation coefficient was derived for postoperative DOI and MRI-detected DOI. A subgroup analysis of superficial tongue cancer was also done. The mean MRI DOI was 13.7 mm and the mean histological DOI 12.45 mm. The shrinkage factor was 0.6 mm. Pearson's correlation coefficient was 0.80 (p=<0.001) for Radiologist 1 and 0.85 (p=<0.001) for Radiologist 2. The interobserver variation was low, with a correlation coefficient between the two radiologists of 0.965 (p=<0.001). For superficial tongue cancers there was moderate correlation for MRI and histologically-detected DOI with a kappa value of 0.681 (p=0.03). As per the ROC curve, the cut-off value for MRI DOI to predict nodal metastasis was 4.6 mm. MRI has high reliability to predict the DOI of tongue cancers. The interobserver variation was low. The diagnostic accuracy in cases of superficial tongue cancer was moderate.
最近发布的第八版美国癌症联合委员会（AJCC）分期系统将浸润深度（DOI）作为其重要组成部分之一。DOI 对于决定表浅舌癌的颈部管理也很重要。磁共振成像（MRI）主要用于评估 DOI，本研究评估了 MRI 检测 DOI 的效能。这是一项回顾性研究，纳入了 2017 年 7 月至 2019 年 6 月间接受手术治疗的 60 例初治舌癌患者。患者在 Optima MR450W 1.5T 磁共振仪上进行 MRI 检查，由 2 名经验丰富的头颈部放射科医生进行 MRI 报告。术后组织学 DOI 被认为是金标准。对术后 DOI 和 MRI 检测到的 DOI 进行了相关系数分析。还对表浅舌癌进行了亚组分析。MRI 平均 DOI 为 13.7mm，平均组织学 DOI 为 12.45mm。收缩因子为 0.6mm。放射科医生 1 的 Pearson 相关系数为 0.80（p<0.001），放射科医生 2 的 Pearson 相关系数为 0.85（p<0.001）。两名放射科医生的观察者间变异较小，相关系数为 0.965（p<0.001）。对于表浅舌癌，MRI 与组织学检测的 DOI 之间具有中度相关性，Kappa 值为 0.681（p=0.03）。根据 ROC 曲线，预测淋巴结转移的 MRI DOI 截断值为 4.6mm。MRI 具有较高的可靠性来预测舌癌的 DOI。观察者间变异较小。表浅舌癌的诊断准确性为中度。
