title: Evaluation of tongue squamous cell carcinoma resection margins using ex-vivo MR.
abstract: OBJECTIVE
  Purpose of this feasibility study was (1) to evaluate whether application of ex-vivo 7T MR of the resected tongue specimen containing squamous cell carcinoma may provide information on the resection margin status and (2) to evaluate the research and developmental issues that have to be solved for this technique to have the beneficial impact on clinical outcome that we expect: better oncologic and functional outcomes, better quality of life, and lower costs.
  
  
  METHODS
  We performed a non-blinded validation of ex-vivo 7T MR to detect the tongue squamous cell carcinoma and resection margin in 10 fresh tongue specimens using histopathology as gold standard.
  
  
  RESULTS
  In six of seven specimens with a histopathologically determined invasion depth of the tumor of [Formula: see text] mm, the tumor could be recognized on MR, with a resection margin within a 2 mm range as compared to histopathology. In three specimens with an invasion depth of [Formula: see text] mm, the tumor was not visible on MR. Technical limitations mainly included scan time, image resolution, and the fact that we used a less available small-bore 7T MR machine.
  
  
  CONCLUSIONS
  Ex-vivo 7T probably will have a low negative predictive value but a high positive predictive value, meaning that in tumors thicker than a few millimeters we expect to be able to predict whether the resection margin is too small. A randomized controlled trial needs to be performed to show our hypothesis: better oncologic and functional outcomes, better quality of life, and lower costs.
authors.affiliation: Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Stefan.Steens@radboudumc.nl.
authors.forename: Stefan C A
authors.initials: SCA
authors.lastname: Steens
authors.affiliation: Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Elise M
authors.initials: EM
authors.lastname: Bekers
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Willem L J
authors.initials: WLJ
authors.lastname: Weijs
authors.affiliation: Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Geert J S
authors.initials: GJS
authors.lastname: Litjens
authors.affiliation: Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Andor
authors.initials: A
authors.lastname: Veltien
authors.affiliation: Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Arie
authors.initials: A
authors.lastname: Maat
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Guido B
authors.initials: GB
authors.lastname: van den Broek
authors.affiliation: Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Jeroen A W M
authors.initials: JAWM
authors.lastname: van der Laak
authors.affiliation: Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Jürgen J
authors.initials: JJ
authors.lastname: Fütterer
authors.affiliation: Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Christina A Hulsbergen
authors.initials: CAH
authors.lastname: van der Kaa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Matthias A W
authors.initials: MAW
authors.lastname: Merkx
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Takes
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D011788:Quality of Life; D000077195:Squamous Cell Carcinoma of Head and Neck; D014059:Tongue / Q000000981:diagnostic imaging; D014062:Tongue Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery
keywords: Ex-vivo; Magnetic resonance imaging; Squamous cell carcinoma; Tongue; Validation