The accuracy of magnetic resonance imaging to measure the depth of invasion in oral tongue cancer: a systematic review and meta-analysis

Li, M.; Yuan, Zhi-Xin; Tang, Zhangui

doi:10.1016/j.ijom.2021.07.010

Cited by 20 publications

(17 citation statements)

References 38 publications

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“…In agreement with those results, the present study showed an overestimation as well, even though the mean difference of 3.9 mm by MRI was slightly larger. On the contrary a subgroup analysis in a systematic review found T1‐weighted MRI images to perform substantially better with a mean difference of 0.77 mm (95% LOA −4.5–6.8) compared to T2‐weighted images with a mean difference of 2.1 mm (95% LOA −5.2–9.5) 31 . However, another important issue is that there is a considerable proportion of patients in whom MRI cannot assess the tumor or DOI at all, especially in T1 tumors 15,16,28–30 .…”

Section: Discussionmentioning

confidence: 91%

“…On the contrary a subgroup analysis in a systematic review found T1‐weighted MRI images to perform substantially better with a mean difference of 0.77 mm (95% LOA −4.5–6.8) compared to T2‐weighted images with a mean difference of 2.1 mm (95% LOA −5.2–9.5). 31 However, another important issue is that there is a considerable proportion of patients in whom MRI cannot assess the tumor or DOI at all, especially in T1 tumors. 15 , 16 , 28 , 29 , 30 These circumstances and the fact that US is a well‐established method to measure tumor thickness have led to expectations in US to assess DOI in early SCCOT defined as T1–T2 according to TNM8.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound accurately assesses depth of invasion in T1‐T2 oral tongue cancer

Nilsson

Knutsson

Landström

et al. 2022

Laryngoscope Investig Oto

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Background Depth of invasion (DOI) is important for the T‐classification of squamous cell carcinoma of the oral tongue (SCCOT) and incorporated in the TNM 8 classification of oral cavity cancer. To determine DOI clinical palpation is performed, but the preferred radiological modality remains controversial. The aim of this study was to investigate the assessment of DOI using ultrasound (US‐DOI). Methods The DOI was assessed in 40 patients with T1–T3 SCCOT by ultrasound, palpation, computed tomography and magnetic resonance imaging (MRI). Histopathological DOI (H‐DOI) was gold standard. Bland–Altman analysis was used to compare mean difference and 95% limits of agreement (LOA). Results The mean difference of US‐DOI was −0.5 mm (95% LOA −4.9–4.0) compared to H‐DOI and the mean difference for MRI was 3.9 mm (95% LOA −2.3–10.2). In the subgroup analysis of cT1‐T2 the US‐DOI mean difference was 0.1 mm and the 95% LOA limits −2.5–2.7. Conclusions Ultrasound seems to be the most accurate method to assess DOI in T1‐T2 SCCOT. MRI overestimates DOI and cannot assess a substantial proportion of the tumors. Level of Evidence 2c.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Ultrasound accurately assesses depth of invasion in T1‐T2 oral tongue cancer

Nilsson

Knutsson

Landström

et al. 2022

Laryngoscope Investig Oto

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“…The ICC coefficient was 0.86 (95% CI 0.83-0.89) for the entire group but even better in the T1WI subgroup (ICC 0.923) than T2WI subgroup (0.79). 19 Authors propose pre-operative IO-USG for all carcinoma tongue (T1-T3) to predict DOI and stage the disease accordingly. This will help in surgical planning.…”

Section: Discussionmentioning

confidence: 99%

Depth of Invasion in Carcinoma Tongue: Evaluation of Clinical and Imaging Techniques

et al. 2023

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Background“Depth of invasion” is an additional index incorporated in 8th AJCC staging system for oral cavity squamous cell carcinoma based on its prognostic significance. Pre‐operative assessment by clinical palpation and imaging modalities has been used with limitations. The aim of the study is to compare different techniques including clinical palpation, ultrasound, and magnetic resonance imaging with histopathology for assessment of depth of tumor invasion.MaterialsFifty patients of carcinoma tongue (T1–T3) were enrolled. Clinical palpation, Ultrasound tongue, and Magnetic resonance imaging were used to assess depth of tumor invasion. Microscopic depth of invasion was considered as reference. Statistical analysis was done to assess the level of agreement, reliability, and internal consistency. ROC analysis was done to find the “Area Under Curve” for microscopic depth versus ultrasound, MRI, and gross histopathological “depth of invasion”.ResultsUltrasound tongue showed highest “area under curve”, Intra class correlation (ICC:0.786) with a good consistency (Cronbach's Alpha:0.880) with histological reference compared to MRI(ICC:0.689;CA:0.816). Clinical palpation showed weak agreement (Kappa:0.43) for assessing depth. To observe the concordance between ultrasound and microscopic depth, Lin's Concordance Correlation Coefficient (CCC = 0.782) was calculated with 95% limits of agreement. Lin's concordance correlation between ultrasound and microscopic depth showed a good agreement.ConclusionsUltrasound tongue is a reliable imaging modality for pre‐operative T staging by assessing tumor “depth of invasion” in carcinoma tongue patients with good internal consistency as per 8th AJCC staging system.Level of EvidenceLevel 2 (CEBM‐Level of Evidence‐2.1) Laryngoscope, 2023

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“…The tongue is a mobile muscular organ commonly affected by squamous cell carcinoma. It has an increased risk of locoregional metastasis and recurrence following excision due to its rich blood supply and abundant lymphatic vessels[ 4 101 ] responsible for distant metastasis, disease recurrence, and associated morbidity and mortality. [ 4 101 ] DOI helps in determining tumor prognosis by predicting this metastasis, helping in better treatment planning.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of magnetic resonance imaging in the assessment of depth of invasion in tongue carcinoma: A systematic review and meta-analysis

Vijayalakshmi,

Jain

2023

National Journal of Maxillofacial Surgery

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Tongue carcinoma constitutes 10.4–46.9% of all oral squamous cell carcinomas (OSCCs) and is notoriously known for invading tissues deeper than the evident gross margins. The deeper the tumor invades, the higher are its chances of future morbidity and mortality due to extensive neck dissection and risk of recurrence. Magnetic resonance imaging (MRI) is a noninvasive diagnostic aid used for measuring a preoperative tumor's depth of invasion (DOI) as it can efficiently outline soft tissue tumors from adjacent normal tissue. To assess various MRI modalities used in measuring DOI in tongue carcinoma and their reliability compared with other DOI measuring modalities. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022330866), and the following Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) Diagnostic Test Accuracy guidelines were performed. PubMed electronic database was searched using a combination of keywords for relevant articles in the English language since 2016. Critical appraisal was carried out using the Quality Assessment of Diagnostic Accuracy Studies-Comparative (QUADAS-C) risk-of-bias (RoB) assessment tool. A weighted mean difference (WMD) was calculated between MRI and histopathological DOI along with pooled correlation and subgroup analysis, where possible. A total of 795 records were retrieved of which 17 were included in the final review with 13 included for meta-analysis. A high RoB was found for most studies for all parameters except flow and timing. WMD showed a statistically significant MRI overestimation of 1.90 mm compared with histopathology. Subgroup analysis showed the 1.5 Tesla machine to be superior to the 3.0 Tesla machine, while imaging sequence subgroup analysis could not be performed. MRI is a viable preoperative DOI measurement modality that can help in efficient treatment planning to decrease surgical morbidity and mortality.

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The accuracy of magnetic resonance imaging to measure the depth of invasion in oral tongue cancer: a systematic review and meta-analysis

Cited by 20 publications

References 38 publications

Ultrasound accurately assesses depth of invasion in T1‐T2 oral tongue cancer

Ultrasound accurately assesses depth of invasion in T1‐T2 oral tongue cancer

Depth of Invasion in Carcinoma Tongue: Evaluation of Clinical and Imaging Techniques

Accuracy of magnetic resonance imaging in the assessment of depth of invasion in tongue carcinoma: A systematic review and meta-analysis

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