Comparison between computed tomography and clinical evaluation in tumour/node stage and follow-up of oral cavity and oropharyngeal cancer

Figueiredo, Paulo Tadeu de Souza; Leite, André Ferreira; Freitas, Antônio Carlos de; Nascimento, Leonel Alves do; Cavalcanti, Marcelo Gusmão Paraíso; Melo, Nilce Santos de; Guerra, Eliete Neves Silva

doi:10.1259/dmfr/69910245

Cited by 14 publications

(7 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among these results, three cases were staged as belonging to the IVA grouping, which represents lesions which are larger and at a more advanced stage, thereby facilitating diagnosis. 15 This confirms the greater importance of the MRI examination for smaller lesions. The definition of grouping by stages is critical in determining the patient's treatment plan, prognosis and survival span.…”

Section: Discussionsupporting

confidence: 54%

“…Calibration of the observers may have been decisive in achieving the agreement levels and should be used in joint training programs that prepare medical and oral radiologists to diagnose oral cancer at reference centers providing multidisciplinary care. 15 There was substantial and significant agreement between the clinical and MRI staging performed by Observers 2 and 4 for N stage. Nevertheless, case number 3, clinically staged as N1, was staged as N0 by two observers (1 and 3) in the MRI examination.…”

Section: Discussionmentioning

confidence: 75%

“…The CT data were published in a previous study. 15 Four observers interpreted the MRI scans. Observers 1 and 2 were dental specialists holding a Master's in oral radiology, and Observers 3 and 4 were medical radiologists.…”

Section: Declaration Of Interestsmentioning

confidence: 99%

See 2 more Smart Citations

Oral cancer staging established by magnetic resonance imaging

et al. 2011

View full text Add to dashboard Cite

The aim of this study was to compare clinical staging and magnetic resonance imaging (MRI) staging for oral cancer, and to assess inter-observer agreement between oral and medical radiologists. A total of 10 patients diagnosed with oral cancer were assessed before treatment. A head and neck surgeon performed clinical TNM staging. Two medical radiologists and two oral radiologists performed a new staging assessment by interpreting MRI scans, without prior knowledge of the clinical staging. They evaluated the extent of the primary tumor (T), metastasis to regional lymph nodes (N) and grouping by stages. The data were analyzed using the Kappa Index. There was significant agreement (p < 0.05) between the clinical and MRI staging assessments made by one oral radiologist for N stage, and between those made by one medical radiologist for the T and N stages and for the grouping by stages. In the MRI assessment, there was significant agreement among all four observers for both T stage and grouping by stages. For the N stage, there was no significant agreement between one oral radiologist and one medical radiologist or between both medical radiologists. There was significant agreement among the remaining radiologists. There was no agreement between the clinical and MRI staging. These results indicate the importance of using MRI for the diagnosis of oral cancer. Training initiatives and calibration of medical and oral radiologists should be promoted to provide an improved multidisciplinary approach to oral cancer.

show abstract

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 75%

See 1 more Smart Citation

Oral cancer staging established by magnetic resonance imaging

et al. 2011

View full text Add to dashboard Cite

show abstract

“…The OMRs also identified a greater number of metastatic lymph nodes on CECT compared with the MRs. A previous study has demonstrated that there were differences between different radiologists in determining the N-stage by CECT, but with significant agreement for the T-stage. 25 Regarding the medical radiologists, a lower agreement was observed between them. This could be explained by the fact that they are general radiologists because in Brazil head and neck radiology is not usually a subspecialty.…”

Section: Discussionmentioning

confidence: 97%

Contrast-enhanced CT and MRI for detecting neck metastasis of oral cancer: comparison between analyses performed by oral and medical radiologists

Figueiredo

Leite²,

Barra³

et al. 2012

Dentomaxillofacial Radiology

View full text Add to dashboard Cite

Objectives: The aim of the study was to verify the concordance of contrast-enhanced CT (CECT) and MRI evaluation among four radiologists in detecting metastatic cervical lymph nodes of oral cancer patients. Methods: Ten patients underwent clinical and imaging examinations (CECT and MRI). Four radiologists, two oral and maxillofacial radiologists (OMRs) and two medical radiologists (MRs), independently analysed the images twice. Cohen's kappa index and Wilcoxon signed-rank test were used to verify the concordance between all analyses. Results: Regarding the interobserver agreement, the OMRs presented excellent kappa values for determining the regional lymph nodes (N-stage) in both CECT and MRI. The MRs presented moderate agreement for CECT evaluation at the first reading, but no concordance was found for the other analyses. When each imaging modality was analysed separately, kappa values were higher between all examiners. Greater variability was demonstrated between Nstage evaluation using different examinations. All radiologists were able to identify a greater number of metastatic lymph nodes in CECT than in MRI, except one MR, but no significant difference was found for all readers. The differences between the number of metastatic lymph nodes among all radiologists were not statistically significant. Moderate intraobserver agreement was observed for CECT and MRI evaluation, except for one MR. Conclusions: The differences found between the N-stage performed by OMRs and MRs support the necessity of a multidisciplinary approach in the imaging evaluation of metastatic nodes. Further studies are necessary to confirm which imaging modality should be employed when evaluating neck areas.

show abstract

“…The rating of possible lymph node metastases is often difficult because of the subjective observerbased cut-off size of suspicious lymph nodes. A size of 10 mm in diameter is often regarded as a borderline morphological cut-off size for positive metastases or for the rating of necrotic tissue areas inside a lymph node (Figueiredo et al, 2010). As CT diagnosis is based purely on morphology, small metastatic lymph nodes and uneventful local tumour recurrence can be overlooked or misinterpreted because of postoperative anatomical changes or distortion, as mentioned above.…”

Section: Ctmentioning

confidence: 99%