MRI prognostic factors of tongue cancer: potential predictors of cervical lymph nodes metastases

Abstract

Background This study aimed to evaluate the efficacy of three MR imaging parameters, which are tumour thickness, para-lingual distance and apparent diffusion coefficient (ADC) value for prediction of cervical lymph nodes metastasis in cancer tongue patients. Patients and methods Fifty patients with proved cancer tongue by histopathological examination underwent MRI examination. T1 and T2- weighted MRI, diffusion-weighted images and post-contrast T1 fat suppression sequences were used. Results The patients were classified according to lymph nodes involvement as seen by MRI into two groups. Significant differences between positive and negative nodes groups were observed regarding tumour thickness and para-lingual distance (p-values = 0.008 and 0.003 respectively). ROC curve analyses revealed cut-off values >13.8 mm and ≤ 3.3 mm for tumour thickness and para-lingual distance respectively for prediction of nodes involvement. No significant differences between patients with and without cervical lymph nodes metastasis were found regarding corresponding ADC value of the tumour (p-value = 0.518). Conclusions Para-lingual distance and tumour thickness are factors that could influence pre-operative judgment and prognosis of tongue cancer patients. ADC value of the tumour itself seem not to be a reliable index of cancer progression to regional lymph nodes.

A Prognostic Model Generated from an Apparent Diffusion Coefficient Ratio Reliably Predicts the Outcomes of Oral Tongue Squamous Cell Carcinoma

“…In agreement with the findings from previous studies on tongue cancer and HNSCC, we found that the pre-treatment ADC value of the tumor was not an important predictor of recurrence [ 20 , 21 ]. However, our findings were not supported by other studies which showed a statistically significant correlation between pre-treatment ADC value of HNSCC and poor prognosis [ 9 , 10 , 11 , 12 , 13 ].…”

“…This is not surprising because the deep invading tumors are closer to deep lymphatics and blood vessels, and thus spread to regional lymph nodes [ 31 ]. We found the optimal cut-off values for tumor thickness were greater than 12.8 mm, which was close to the best cutoff values observed in another study [ 20 ]. High LNR were also reported to be associated with poor survival and high disease recurrence rates in tongue cancer [ 32 , 33 , 34 ].…”

Polymorphous Adenocarcinoma: A Systematic Review of the Literature and Presentation of Two Cases in a Less-Considered Anatomical Site

“…Regarding the location of the tumour, the greater tendency of tumours located at the base of the tongue to metastasize could be related to their anatomical characteristics, such as their vascularization and the proximity to the cervical lymph nodes [63,64]. Therefore, depth of invasion is an important prognostic factor [65].…”

Imaging the Micron: New Directions in Diagnosis with Ultra-High-Frequency Ultrasound

“…Importantly, the parameter of depth of invasion was established as a predictor of the presence of lymph node metastases [48][49][50] and was added as a T-category modifier to the 8th edition of the American Joint Committee on Cancer criteria in 2017 [51][52][53]. Several studies have investigated the ability of diagnostic imaging to evaluate tumor dimensions [54][55][56]; a recent systematic review compared the diagnostic accuracy of magnetic resonance, computed tomography, and ultrasonography in assessing tumor dimensions preoperatively [57]. For magnetic resonance, the sensitivity was >80% and the specificity was >75% in all the studies included in the review, while computed tomography was reported in one study to have a sensitivity of 68.75% and a specificity of 77.78%.…”