Squamous cell carcinomas that arise in the oral cavity and tongue base: can CT help predict perineural or vascular invasion?
OBJECTIVE
To determine the ability to use computed tomography (CT) to predict invasion of adjacent nerves or vessels by oral cavity tumors.


METHODS
Contrast material-enhanced CT scans and histopathologic reports were retrospectively reviewed in 48 patients (36 men, 12 women) aged 38-75 years who underwent gross total resection of squamous cell carcinomas arising in the tongue, the base of the tongue, and the floor of the mouth. CT criteria for diagnosis of perineural or vascular invasion were aggressive tumor margins, invasion of the sublingual space, and direct adjacency of the tumor to the enhanced lingual vasculature in the sublingual space. CT and histopathologic findings of perineural and/or vascular invasion by tumor were correlated in all patients.


RESULTS
With the above criteria, CT findings predictive of perineural or vascular invasion had a sensitivity of 88%; specificity, 83%; positive predictive value, 85%; and negative predictive value, 84%.


CONCLUSIONS
CT findings can be used to predict perineural or vascular invasion by oral cavity tumors.
Department of Radiology, University of North Carolina School of Medicine, Chapel Hill 27599-7510, USA.
S K
SK
Mukherji
S M
SM
Weeks
M
M
Castillo
B C
BC
Yankaskas
L A
LA
Krishnan
S
S
Schiro
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000098:blood supply / Q000294:innervation; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014062:Tongue Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology