Department of Anesthesiology, Oncology and Radiology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP, Brazil.
Post-Graduate Program in Dentistry, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2022 Nov-Dec;88 Suppl 4(Suppl 4):S117-S123. doi: 10.1016/j.bjorl.2022.07.001. Epub 2022 Jul 29.
Oral Squamous Cell Carcinoma (OSCC) is conventionally treated by surgical resection, and positive surgical margins strongly increase local recurrence and decrease survival. This study aimed to evaluate whether a Three-Dimensional Segmentation (3DS) image of OSCC confers advantage over Multiplanar Reconstruction (MPR) of OSCC using images of computed tomography scan in surgical planning of tumor resection.
Twenty-six patients with locally advanced OSCC had tumor morphology and dimensions evaluated by MPR images, 3DS images, and Surgical Pathology Specimen (SPS) analyses (gold standard). OSCC resection was performed with curative intent using only MPR images.
OSCC morphology was more accurately assessed by 3DS than by MPR images. Similar OSCC volumes and dimensions were obtained when MPR images, 3DS images and SPS measurements were considered. Nevertheless, there was a strong correlation between the OSCC longest axis measured by 3DS and SPS analyses (ICC = 0.82; 95% CI 0.59‒0.92), whereas only a moderate correlation was observed between the longest axis of OSCC measured by MPR images and SPS analyses (ICC = 0.51; 95% CI 0.09‒0.78). Taking only SPS with positive margins into account, MPR images and 3DS images underestimated the tumor's longest axis in eight out of 11 (72.7%) and 5 out of the 11 (45.5%) cases, respectively.
Our data present preliminary evidence that 3DS model represents a useful tool for surgical planning of OSCC resection, but confirmation in a larger cohort of patients is required.
Laboratory study.
口腔鳞状细胞癌（OSCC）通常采用手术切除进行治疗，阳性手术切缘会强烈增加局部复发率并降低生存率。本研究旨在评估 OSCC 的三维分割（3DS）图像是否优于 OSCC 的多平面重建（MPR）图像，以在肿瘤切除的手术计划中使用计算机断层扫描图像。
26 例局部晚期 OSCC 患者的肿瘤形态和尺寸分别通过 MPR 图像、3DS 图像和手术病理标本（金标准）进行评估。仅使用 MPR 图像进行 OSCC 根治性切除术。
3DS 图像比 MPR 图像更能准确评估 OSCC 的形态。当考虑 MPR 图像、3DS 图像和 SPS 测量值时，OSCC 的体积和尺寸相似。然而，3DS 测量的 OSCC 最长轴与 SPS 分析之间存在很强的相关性（ICC=0.82；95%CI 0.59‒0.92），而 MPR 图像测量的 OSCC 最长轴与 SPS 分析之间仅存在中度相关性（ICC=0.51；95%CI 0.09‒0.78）。仅考虑有阳性切缘的 SPS，MPR 图像和 3DS 图像分别在 11 例中的 8 例（72.7%）和 5 例（45.5%）中低估了肿瘤的最长轴。
我们的数据初步表明，3DS 模型是 OSCC 切除手术计划的有用工具，但需要在更大的患者队列中进行验证。
实验室研究。
