Aims and objectives
Head and neck cancer ranks tenth in the world for cancer mortality [4].
Most cases of mouth cavity cancer are squamous cell carcinomas (SCC).
Tongue cancer accounts for 22 percent of oral cancer [5].
Recent years’ diagnostics of head and neck cancer significantly improved due to the use of MDCT.
MDCT gives additional information to the instrumental examination.
This radiological method is included in the gold standard of evaluation of locally advanced tongue cancer [1,
3,
6].
Multimodal treatment of cancer results to additional difficulties...
Methods and materials
Study included 74 patients (63 male and 11 female,
average age 59 years) with diagnosed tongue cancer after combined treatment.
The morphological diagnosis of residual/recurrent SCC of the tongue was established in 39 cases.
In the rest of patients,
this diagnosis was rejected and different post-surgery/post-therapeutic changes were found.
Contrast-enhanced MDCT of the head and neck was performed with 64-row scanner.
Qualitative analysis of tumor’s volume,
pattern of contrast enhancement was performed.
The following MDCT protocol was used: scan thickness 0.5 mm with subsequent reconstruction...
Results
True-positive diagnosis of residual/recurrent tongue cancer by MDCT was established in 33 of 39 cases [Fig.
1,
2].
Six false-negative cases occurred in patients with lack of tumor’s contrast enhancement due to necrotic changes.
MDCT correctly excluded the recurrent or residual tumor in 28 patients (they had post-radial edema/post-surgical changes [Fig.
4]).
False-positive results consisted of 9 cases of edge effect accumulation of contrast on the background of postoperative/post-radial inflammatory changes at the border of media (soft tissues – air [Fig.
3]).Sensitivity,
specificity,
accuracy,
PPV...
Conclusion
In most cases of suspected recurrent/residual SCC of the tongue,
the contrast-enhanced MDCT allows to differentiate tumor from post-surgery/post-therapeutic changes.
MDCT is the method of choice for examining patients with suspected recurrent/residual SCC of the tongue.
In unclear cases,
it is additionally advised to perform MRI and PET-CT.
Personal information
V.
Petrovichev,MD,
PhD,
radiologist in the Centre of Medicine and Rehabilitation of Minzdrav,
Moscow,
Russian Federation;

[email protected]
P.
Vasil'ev,
MD,
PhD,radiologist inClinical Oncology Dispensary One,
Moscow Healthcare Department,
Moscow,
Russian Federation;

[email protected]
E.
Mershina,MD,
PhD,
Head of Department of Tomography in the Centre of Medicine and Rehabilitation of Minzdrav,
Moscow,
Russian Federation;
[email protected]
V.
Sinitsyn,
MD,
PhD,
Professor,
Head of the Centre of Diagnostic Radiology in the Centre of Medicine and Rehabilitation of Minzdrav,
Moscow,
Russian Federation;
[email protected]
References
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Blatt S et al.
Diagnosing oral squamous cell carcinoma: How much imaging do we really need? A review of the current literature.
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doi: 10.1016/j.jcms.2016.02.003.
Epub 2016 Feb 18.
2.
Garcia MR et al.
Postsurgical imaging of the oral cavity and oropharynx: what radiologists need to know.
Radiographics.
2015 May-Jun;35(3):804-18.
doi: 10.1148/rg.2015140077.
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Sarrion Perez MG,
Bagan JV,
Jimenez Y,
Margaix M,
Marzal C: Utility of imaging techniques in the diagnosis of oral cancer.
J Craniomaxillofac Surg.
43:1880-1894,
2015
4....