title: The advantages and drawbacks of routine magnetic resonance imaging for long-term post-treatment locoregional surveillance of oral cavity squamous cell carcinoma.
abstract: OBJECTIVE
  Assess the clinical utility and accuracy of routine surveillance head and neck magnetic resonance imaging (HN-MRI) for the detection of locoregional recurrence in patients with a history of oral cavity squamous cell carcinoma (OCSCC) without concurrent suspicious symptoms or signs 6 months or more after treatment.
  
  
  METHODS
  For OCSCC patients who underwent routine (defined as: without concurrent suspicious symptoms or signs) surveillance HN-MRI at 6 months or more after treatment completion, we retrospectively determined the detection rate of locoregional disease and false positive rate.
  
  
  RESULTS
  Out of an original cohort of 533 OCSCC patients, 46 patients, who were disease-free 6 months after treatment, had undergone 108 routine HN-MRIs from 6 to 48 months after surgery without the presence of concurrent suspicious symptoms or signs and had 6 months of subsequent follow up. 1 out of 46 (2.2%) had a true positive regional recurrence. 10 out of 46 (21.7%) patients experienced a false positive locoregional finding.
  
  
  CONCLUSIONS
  Routine HN-MRI for locoregional surveillance of OCSCC, when used in patients without concurrent suspicious symptoms or exam findings over 6 months since treatment, may be unnecessary and costly given the very low rate of recurrence and high false positive rate. Our study supports the National Comprehensive Cancer Network guideline of limiting imaging after 6 months of primary treatment completion to patients with suspicious clinical findings. Nonetheless, managing physicians should continue to be empowered to use surveillance imaging based on risk profiles and unique circumstances for each patient.
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, CA, USA.
authors.forename: Fatemah A
authors.initials: FA
authors.lastname: Al-Shwaiheen
authors.affiliation: Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Wang
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Alina
authors.initials: A
authors.lastname: Uzelac
authors.affiliation: Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Sue S
authors.initials: SS
authors.lastname: Yom
authors.affiliation: Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA. Electronic address: wryan@ohns.ucsf.edu.
authors.forename: William R
authors.initials: WR
authors.lastname: Ryan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015996:Survival Rate