CT Accuracy of Extrinsic Tongue Muscle Invasion in Oral Cavity Cancer

Junn, Jacqueline C.; Baugnon, Kristen L.; Lacayo, Eduardo A.; Rhyner, Patricia A.; Patel, Mitesh; Magliocca, Kelly R.; Corey, Amanda S.; El‐Deiry, Mark W.; Wadsworth, J. Trad; Beitler, J.J.; Saba, Nabil F.; Liu, Y.; Aiken, Ashley H.

doi:10.3174/ajnr.a4993

Cited by 11 publications

(3 citation statements)

References 21 publications

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“…A comprehensive exploration of cases and the detection of neck metastases necessitate clinical examination and modern imaging techniques such as ultrasound, MRI, CT, and positron emission tomography (PET) [ 1 , 10 , 11 ]. Despite the assistance provided by diagnostic technologies, as many as 20–30% of clinically N0 patients are discovered to have a metastatic involvement of cervical lymph nodes during elective neck dissection (END) [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”

Ionna,

Pavone,

Aversa

et al. 2024

Cancers

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Oral tongue squamous-cell carcinoma (OTSCC) is the most prevalent malignancy in the head and neck region. Lymphatic spread, particularly to cervical lymph nodes, significantly impacts 5-year survival rates, emphasizing the criticality of precise staging. Metastatic cervical lymph nodes can decrease survival rates by 50%. Yet, elective neck dissection (END) in T1–2 cN0 patients proves to be an overtreatment in around 80% of cases. To address this, sentinel lymph node biopsy (SLNB) was introduced, aiming to minimize postoperative morbidity. This study, conducted at the ENT and Maxillofacial Surgery department of the Istituto Nazionale Tumori in Naples, explores SLNB’s efficacy in early-stage oral tongue squamous-cell carcinoma (OTSCC). From January 2020 to January 2022, 122 T1/T2 cN0 HNSCC patients were enrolled. Radioactive tracers and lymphoscintigraphy identified sentinel lymph nodes, aided by a gamma probe during surgery. Results revealed 24.6% SLN biopsy positivity, with 169 SLNs resected and a 21.9% positivity ratio. The study suggests SLNB’s reliability for T1-2 cN0 OTSCC patient staging and early micrometastasis detection.

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Section: Introductionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”

Ionna,

Pavone,

Aversa

et al. 2024

Cancers

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“…CT is widely used as the basic imaging modality in the preoperative evaluation of patients with OTSCC. Previous studies have demonstrated the utility of CT for primary tumors, such as in cases of invasion of the neurovascular bundle, extrinsic muscular invasion, mandibular invasion, and DOI measurement [4][5][6][7][8]. Furthermore, CT allows for the assessment of distant metastases in addition to primary tumors and nodal metastases.…”

Section: Introductionmentioning

confidence: 99%

Subtraction iodine imaging with area detector CT to improve tumor delineation and measurability of tumor size and depth of invasion in tongue squamous cell carcinoma

et al. 2021

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Purpose Tumor size and depth of invasion (DOI) are mandatory assessments for tumor classification in tongue cancer but are often non-assessable on CT due to dental artifacts. This study investigated whether subtraction iodine imaging (SII) would improve tumor delineation and measurability. Materials and methods Fifty-seven consecutive patients with tongue cancer, who underwent scanning with a 320-row area detector CT with contrast administration and were treated with surgical resection, were retrospectively evaluated. CT was reconstructed with single-energy projection-based metallic artifact reduction (sCT). SII was generated by subtracting the pre-contrast volume scans from the post-contrast volume scans using a high-resolution deformable registration algorithm. MRI scans were also evaluated for comparing the ability of measurements. Two radiologists visually graded the tumor delineation using a 5-point scale. Tumor size and DOI were measured wherever possible. The tumor delineation score was compared using the Wilcoxon signed-rank method. Spearman’s correlations between imaging and pathological measurements were calculated. Intraclass correlation coefficients of measurements between readers were estimated. Results The tumor delineation score was greater on sCT-plus-SII than on sCT alone (medians: 3 and 1, respectively; p < 0.001), with higher number of detectable cases observed with sCT-plus-SII (36/57 [63.2%]) than sCT alone (21/57 [36.8%]). Tumor size and DOI measurability were higher with sCT-plus-SII (29/57 [50.9%]) than with sCT alone (17/57 [29.8%]). MRI had the highest detectability (52/57 [91.2%]) and measurability (46/57 [80.7%]). Correlation coefficients between radiological and pathological tumor size and DOI were similar for sCT (0.83–0.88), sCT-plus-SII (0.78–0.84), and MRI (0.78–0.90). Intraclass correlation coefficients were higher than 0.95 for each modality. Conclusions SII improves detectability and measurability of tumor size and DOI in patients with oral tongue squamous cell carcinoma, thus increasing the diagnostic potential. SII may also be beneficial for cases unevaluable on MRI due to artifacts or for patients with contraindications to MRI.

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“…4 At the beginning of this century, the more frequent approach was a wide resection with larger free macroscopic margins (1.5-2 cm). 5 Today we can better plan how to perform tongue tumor removal as a result of improved knowledge of the manner of superficial and deeper local tumoral spread along the muscles, the nerves, and the vessels, [6][7][8][9][10][11][12] improved imaging techniques, 13,14 which allow surgeons to evaluate the involvement of each tongue muscle, and the new eighth edition American Joint Committee on Cancer (AJCC) TNM staging system. [15][16][17] From a functional point of view, we should also underline that tongue resection often partially cut the muscles in such way that they lose their function.…”

Section: Introductionmentioning

confidence: 99%

Classification of GLOSSECTOMIES: Proposal for tongue cancer resections

et al. 2019

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Background Surgery of tongue tumors includes different procedures ranging from mucosal resection to complex combined resection. Numerous terms have been used to describe such procedures, but there is no consensus between the terminology and the extent of resection. Methods and Results We searched the medical literature and found a lack of published information. We undertook to describe a new classification of surgical procedures for tongue tumor resection. We based it upon the surgical anatomy of the tongue and the spread of the cancer. We posited that there were five major types of glossectomy embracing all the methods of tongue cancer resection. This classification was reviewed and endorsed by an international team of experts. Conclusion We propose a more precise classification than that currently in practice, thereby bringing clarity and consistency to the terminology, facilitating shared communication between surgeons, comparison between published research, and ultimately improving surgical practice and patient care.

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CT Accuracy of Extrinsic Tongue Muscle Invasion in Oral Cavity Cancer

Cited by 11 publications

References 21 publications

Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”

Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”

Subtraction iodine imaging with area detector CT to improve tumor delineation and measurability of tumor size and depth of invasion in tongue squamous cell carcinoma

Classification of GLOSSECTOMIES: Proposal for tongue cancer resections

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