Relationship between histologic thickness of tongue carcinoma and thickness estimated from preoperative MRI

Abstract

Several studies have shown that the thickness of tongue carcinoma is related to prognosis and to the likelihood of cervical node metastases. We investigated whether preoperative estimates of tumor thickness and volume, as determined from magnetic resonance imaging (MRI), correlated with histologic thickness and might therefore predict the presence of neck metastases. We assessed relationships between histologic tumor thickness and MRI tumor thickness and volume in a retrospective series of 33 patients with squamous cell carcinoma of the tongue. Thicknesses were determined by direct measurement and by considering corrections for ulceration or tumor vegetation (reconstructed thickness). Relationships between MRI thickness and the presence or absence of homolateral and contralateral nodal metastases were also investigated. We found that MRI thicknesses correlated strongly and directly with histologic tumor thicknesses, although mean MRI thicknesses were significantly greater than histologic thicknesses. MRI thicknesses were significantly greater in patients with contralateral neck involvement than in those with no neck involvement. We conclude that MRI provides an accurate and reproducible means of estimating the thickness of tongue carcinomas, paving the way for further studies on more extensive series of patients to determine whether preoperatively determined MRI thickness can reliably predict homolateral and bilateral neck involvement.

Tumor Thickness and Paralingual Distance of Coronal MR Imaging Predicts Cervical Node Metastases in Oral Tongue Carcinoma

“…[19][20][21] MR imaging thickness in patients with metastatic lymph nodes tended to be greater than that in metastases-free patients, though the difference was not significant between patients with and without metastasis. 21 Tongue carcinoma varies in the tumor shape (reductive or expansive) and in the growth pattern (endophytic or exophytic). Therefore, how far tumor cells invade and which structures these cells infiltrate, rather than tumor thickness, may be important.…”

“…In MR imaging, the structures of normal tongue architecture and the oral tongue carcinoma can be clearly shown, and coronal MR imaging can also be used to satisfactorily measure the thickness of oral tongue carcinoma. 19 Preda et al 21 found that tumor thickness of tongue carcinoma on MR imaging correlated directly with the histologic tumor thickness, and mean tumor thickness in patients with lymph node metastases was greater than that of those without metastases; but the difference did not reach significance in 33 patients. In our 43 patients, the tumor thickness was significantly (P Ͻ .05) associated with lymph node metastases, and the thickness was a statistically significant predictor of lymph node metastases in multivariate logistic re- gression analysis.…”

Imaging in benign and malignant mass lesions of the tongue

“…7 The lateromedial thickness taken in axial MR plane is used as the precise measurement for assessing the tumors from the lateral border of the tongue. [8][9][10][11] Another study by Okura et al established that a tumour with thickness > 9.7 mm as a significant predictor for nodal metastasis. 8 The other predictors for staging the tumor is to assess the involvement of muscles with or without crossing the midline, extension into floor of mouth, valleculae, pre epiglottic space and the hyoid bone.…”

“…8 The other predictors for staging the tumor is to assess the involvement of muscles with or without crossing the midline, extension into floor of mouth, valleculae, pre epiglottic space and the hyoid bone. [9][10][11] The involvement of valleculae, pre epiglottic space and hyoid bone indicates relative contra indication for surgical resection.…”

Management for the N0 Neck of SCC in the Oral Cavity

“…Accordingly, multi-sliced imaging techniques should be useful and convenient. Recently, the correlation between histologic tumor thickness and magnetic resonance imaging (MRI) tumor thickness was demonstrated (Iwai et al 2002;Lam et al 2004;Preda et al 2006). Then MRI tumor thickness seems to become a candidate of occult metastatic predictor, although these studies did not reach to demonstrate the relation with MRI tumor thickness and regional metastases.…”