title: Cone-beam CT in the assessment of mandibular invasion by oral squamous cell carcinoma: results of the preliminary study.
abstract: This preliminary retrospective study evaluates the diagnostic value of cone-beam computed tomography (CBCT), as a potential standard preoperative procedure, in assessing mandibular invasion by oral squamous cell carcinoma (OSCC) compared with conventional preoperative panoramic radiography (PR), magnetic resonance imaging (MRI) and histological examination of the resection specimen (the golden standard). Between September 2006 and September 2009, 23 patients with histology proven primary OSCC, adjacent to or fixed to the mandible were included. The tumours were classified into four groups, ranging from no bone invasion to evident bone invasion. Sensitivity and specificity for PR were 55% (95% CI [0.350;0.619]) and 92% (95% CI 0.737;0.984]), respectively, both were significantly lower than the 91% (95% CI [0.740;0.909]) and 100% (95% CI [0.845;1]), respectively, for CBCT. MRI showed 82% sensitivity (95% CI [0.608;0.941]) and 67% specificity (95% CI [0.474;0.779]). CBCT has the potential to become a new diagnostic tool in the OSCC screening procedure to predict mandibular invasion or erosion, but its value may be limited by its relatively low sensitivity. A prospective study will start on 64 patients (alpha=0.05; power 0.8; effect size 0.5) to improve these results statistically.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: A W F
authors.initials: AW
authors.lastname: Hendrikx
authors.forename: T
authors.initials: T
authors.lastname: Maal
authors.forename: F
authors.initials: F
authors.lastname: Dieleman
authors.forename: E M
authors.initials: EM
authors.lastname: Van Cann
authors.forename: M A W
authors.initials: MA
authors.lastname: Merkx
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D054893:Cone-Beam Computed Tomography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging; D010865:Pilot Projects; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D012680:Sensitivity and Specificity