Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Eur Radiol. 2023 Feb;33(2):845-853. doi: 10.1007/s00330-022-09075-w. Epub 2022 Aug 20.
To compare the delineation of mandibular cancer by 3D T1 turbo field echo with compressed SENSE (CS-3D-T1TFE) images and MDCT images, and to compare both sets of images with histopathological findings, as the gold standard, to validate the accuracy and clinical usefulness of CS-3D-T1TFE reconstruction.
Twenty-four patients with mandibular squamous cell carcinoma (SCC) who underwent MRI including CS-3D-T1TFE and MDCT examinations before surgery were retrospectively included. For both examinations, 0.5-mm-thick coronal plane images and 0.5-mm-thick plane images perpendicular and parallel to the dentition were constructed. Two radiologists rated bone invasion in three categories indexed by cortical bone, cancellous bone, and mandibular canal (MC), and inter-rater agreement was assessed by weighted kappa statistics. In 20 of the 24 patients who underwent surgery, the correlation of bone invasion with the histopathological evaluation by pathologists was assessed using Pearson's correlation coefficient. Soft-tissue invasion was assessed by diagnosing the presence of invasion into the mylohyoid muscle, gingivobuccal fold, and masticator space, and inter-rater agreement was assessed by kappa statistics.
The interobserver agreement for bone invasion assessment was almost perfect with CS-3D-T1TFE and substantial with MDCT. The image evaluations by both observers agreed with the pathological evaluations in 15 of the 20 cases, showing high correlation (r > 0.8). CS-3D-T1TFE also showed higher inter-rater agreement than MDCT for all measures of soft-tissue invasion.
CS-3D-T1TFE reconstructed images were clinically useful in accurately depicting the extent of mandibular cancer invasion and potentially solving the problem of lesion overestimation associated with conventional MRI.
• Reconstructed CS-3D-T1TFE images were useful for the diagnosis of mandibular cancer. • CS-3D-T1TFE images showed higher inter-rater agreement than MDCT and high correlation with pathological findings. • CS-3D-T1TFE images may solve the problem of overestimation of the tumor extent, which has been associated with MRI in the past.
比较 3D T1 涡轮回波压缩敏感（CS-3D-T1TFE）与 MDCT 图像对下颌骨癌的勾画，并与病理结果作为金标准比较，验证 CS-3D-T1TFE 重建的准确性和临床实用性。
回顾性纳入 24 例术前接受 MRI 包括 CS-3D-T1TFE 和 MDCT 检查的下颌骨鳞状细胞癌（SCC）患者。两种检查均构建 0.5mm 厚的冠状面图像和垂直、平行于牙列的 0.5mm 厚的层面图像。两名放射科医生对皮质骨、松质骨和下颌管（MC）三个类别进行骨侵犯评分，并采用加权 Kappa 统计评估组间一致性。在 24 例患者中的 20 例进行了手术，采用 Pearson 相关系数评估骨侵犯与病理评估的相关性。通过判断是否侵犯下颌舌骨肌、龈颊皱襞和咀嚼肌间隙来评估软组织侵犯，并采用 Kappa 统计评估组间一致性。
CS-3D-T1TFE 组和 MDCT 组的骨侵犯评估观察者间一致性均为几乎完美。两名观察者的图像评估与 20 例中的 15 例病理评估一致，显示高度相关性（r>0.8）。CS-3D-T1TFE 组还显示出比 MDCT 组更高的软组织侵犯的观察者间一致性。
CS-3D-T1TFE 重建图像在准确描述下颌骨癌侵犯范围方面具有临床应用价值，有可能解决与常规 MRI 相关的病变高估问题。
重建的 CS-3D-T1TFE 图像有助于诊断下颌骨癌。
CS-3D-T1TFE 图像与 MDCT 相比具有更高的组间一致性，与病理结果具有高度相关性。
CS-3D-T1TFE 图像可能解决过去与 MRI 相关的肿瘤范围高估问题。
