title: Quantitative dynamic contrast-enhanced MRI for the assessment of mandibular invasion by squamous cell carcinoma.
abstract: The objective of this study was to determine the value of dynamic contrast-enhanced MRI (DCE-MRI) for the preoperative assessment of mandibular invasion in squamous cell carcinomas (SCC), adjacent or fixed to the mandible. DCE-MRI was performed with gadolinium diethylene triamine pentaacetic acid (Gd-DTPA). Data were obtained from 25 patients. From pharmacokinetic analysis of the tissue uptake of Gd-DTPA, the DCE-MRI parameters (k(ep), K(trans) and v(e)) were determined, with k(ep) representing the exchange rate constant, K(trans) the volume transfer constant and v(e) the volume of extracellular space per unit volume of tissue. The histology of the resection specimens was used as gold standard for the extent of mandibular invasion. SCC with medullary invasion showed higher mean k(ep) and K(trans) compared with SCC without medullary invasion (ANOVA, p<0.001). ROC analysis of k(ep) and K(trans) revealed reliable threshold values for medullary invasion. In conclusion, DCE-MRI can discriminate SCC with medullary invasion from SCC without medullary invasion and may serve as a valuable tool in preoperative tumour staging with regard to the delineation of medullary invasion.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. e.m.vancann@umcutrecht.nl
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Van Cann
authors.forename: Mark
authors.initials: M
authors.lastname: Rijpkema
authors.forename: Arend
authors.initials: A
authors.lastname: Heerschap
authors.forename: Andries
authors.initials: A
authors.lastname: van der Bilt
authors.forename: Ron
authors.initials: R
authors.lastname: Koole
authors.forename: Paul J W
authors.initials: PJ
authors.lastname: Stoelinga
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008339:Mandibular Neoplasms / Q000473:pathology*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D009361:Neoplasm Invasiveness; D011300:Preoperative Care
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA