Advertisement

Reliability of MRI-Derived Depth of Invasion of Oral Tongue Cancer

Published:September 26, 2018DOI:https://doi.org/10.1016/j.acra.2018.08.021

      Rationale and Objective

      To evaluate the inter-rater reliability of the magnetic resonance imaging (MRI)-derived depth of invasion (DOI) and the agreement between MRI and pathological measurements of oral tongue cancer.

      Materials and Methods

      The institutional review board approved this retrospective study. The study population consisted of 29 patients with clinical T2N0 oral tongue cancer treated by surgery. Routine pretreatment MRI was performed on a 3T superconducting imager. Two raters with 23 and 18 years of head-and-neck MRI experience, respectively, independently chosen MRI sequences for each patient, then delineate the tumor, and then used three protocols to measure the MRI-derived DOI: the axial reconstructed thickness (method 1), the axial invasive portion (method 2), and the coronal invasive portion (method 3). Then they consensually selected the optimal among the three methods for each patient; it was designated method 4. The Bland-Altman plots, intraclass correlation coefficients (ICCs), and the paired samples test were used. According to the median follow-up of 41 months, the relationship between the MRI-derived DOI and nodal recurrence was also investigated.

      Results

      The inter-rater reliability of methods 2 and 4 was excellent (ICC of 0.829 and 0.807, respectively). The correlation between MRI and pathological measurements was good for method 4 (ICC of 0.611), however, all measurements recorded on MRI were 2–3 mm larger than on pathology. No patients whose MRI-derived DOI was less than 5 mm suffered nodal recurrence.

      Conclusion

      The MRI-derived DOI was valuable for the preoperative staging. The optimal measurement method should be selected on a case-by-case basis.

      Key Words

      Abbreviations:

      AJCC (American Joint Committee on Cancer), DOI (depth of invasion), ICC (intraclass correlation coefficient), MRI (magnetic resonance imaging), UICC (Union for International Cancer Control)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Radiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Iwai H
        • Kyomoto R
        • Ha-Kawa SK
        • et al.
        Magnetic resonance determination of tumor thickness as predictive factor of cervical metastasis in oral tongue carcinoma.
        Laryngoscope. 2002; 112: 457-461
        • Preda L
        • Chiesa F
        • Calabrese L
        • et al.
        Relationship between histologic thickness of tongue carcinoma and thickness estimated from preoperative MRI.
        Eur Radiol. 2006; 16: 2242-2248
        • Goel V
        • Parihar PS
        • Parihar A
        • et al.
        Accuracy of MRI in prediction of tumour thickness and nodal stage in oral tongue and gingivobuccal cancer with clinical correlation and staging.
        J Clin Diagn Res. 2016; 10 (TC01–05)
        • Park JO
        • Jung SL
        • Joo YH
        • et al.
        Diagnostic accuracy of magnetic resonance imaging (MRI) in the assessment of tumor invasion depth in oral/oropharyngeal cancer.
        Oral Oncol. 2011; 47: 381-386
        • Kwon M
        • Moon H
        • Nam SY
        • et al.
        Clinical significance of three-dimensional measurement of tumour thickness on magnetic resonance imaging in patients with oral tongue squamous cell carcinoma.
        Eur Radiol. 2016; 26: 858-865
        • Hu H
        • Cheng KL
        • Xu XQ
        • et al.
        Predicting the prognosis of oral tongue carcinoma using a simple quantitative measurement based on preoperative MR Imaging: Tumor thickness versus tumor volume.
        Am J Neuroradiol. 2015; 36: 1338-1342
        • Imai T
        • Satoh I
        • Matsumoto K
        • et al.
        Retrospective observational study of occult cervical lymph-node metastasis in T1N0 tongue cancer.
        Jpn J Clin Oncol. 2017; 47: 130-136
        • Okura M
        • Iida S
        • Aikawa T
        • et al.
        Tumor thickness and paralingual distance of coronal MR imaging predicts cervical node metastases in oral tongue carcinoma.
        AJNR Am J Neuroradiol. 2008; 29: 45-50
        • Lam P
        • Au-Yeung KM
        • Cheng PW
        • et al.
        Correlating MRI and histologic tumor thickness in the assessment of oral tongue cancer.
        AJR Am J Roentgenol. 2004; 182: 803-808
        • Matsubara R
        • Kawano S
        • Chikui T
        • et al.
        Clinical significance of combined assessment of the maximum standardized uptake value of F-18 FDG PET with nodal size in the diagnosis of cervical lymph node metastasis of oral squamous cell carcinoma.
        Acad Radiol. 2012; 19: 708-717
      1. Furukawa M, Dillon JK, Futran ND, et al. The prevalence of lymph node metastases in clinically N0 necks with oral cavity squamous cell carcinoma: is CT good enough for nodal staging? Acta Radiol. 2014; 55:570–578.

        • Murakami R
        • Uozumi H
        • Hirai T
        • et al.
        Impact of FDG-PET/CT imaging on nodal staging for head-and-neck squamous cell carcinoma.
        Int J Radiat Oncol Biol Phys. 2007; 68: 377-382
        • Murakami R
        • Uozumi H
        • Hirai T
        • et al.
        Impact of FDG-PET/CT fused imaging on tumor volume assessment of head-and-neck squamous cell carcinoma: Intermethod and interobserver variations.
        Acta Radiol. 2008; 49: 693-699
        • Aiken AH
        • Poliashenko S
        • Beitler JJ
        • et al.
        Accuracy of preoperative imaging in detecting nodal extracapsular spread in oral cavity squamous cell carcinoma.
        AJNR Am J Neuroradiol. 2015; 36: 1776-1781
        • Brierley JD
        • Gospodarowicz MK
        • Wittekind C
        TNM classification of malignant tumours.
        8th. John Wiley & Sons, Inc., Chichester, West Sussex, UK2017
        • Amin MB
        • Edge SB
        • Greene FL
        • et al.
        AJCC Cancer Staging Manual.
        8th. Springer, New York2017
        • Huang SH
        • O'Sullivan B
        Overview of the 8th Edition TNM Classification for Head and Neck Cancer.
        Curr Treat Options Oncol. 2017; 18: 40
        • Lydiatt WM
        • Patel SG
        • O'Sullivan B
        • et al.
        Head and neck cancers: major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.
        CA Cancer J Clin. 2017; 67: 122-137
        • Cicchetti DV
        Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology.
        Psychol Assess. 1994; 6: 284-290
        • Johnson RE
        • Sigman JD
        • Funk GF
        • et al.
        Quantification of surgical margin shrinkage in the oral cavity.
        Head Neck. 1997; 19: 281-286