Accuracy of diagnostic mandibular invasion of oral squamous cell carcinoma perioperative assessment by Cone beam computed tomography
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Abstract
Abstract
Background: The main treatment option of oral squamous cell carcinoma (SCCA) is surgery, but tumor
progression during waiting time which may invade the mandible that segmental mandibulectomy and
reconstruction are necessary. CT scan is the ideal choice for evaluating tumor progression, but is
not available. As a result, Cone beam CT (CBCT) is considered to be used to evaluate mandibular
invasion, since it is easy to use, does not take time, decrease metal artifacts and uses low dose
of radiation.
Objectives: To evaluate the accuracy of preoperative CBCT for diagnosis mandibular invasion of oral
SCCA by surgical team and evaluate the effect of preoperative CBCT to plan of surgery.
Materials and methods: Retrospective cohort study, 76 patients with oral SCCA who underwent
operation were examined by preoperative CBCT between Jan 2021 -Sep 2022. Surgical team and one
radiologist evaluates CBCT for the presence or absence of mandibular invasion and compared with
histopathological as the gold standard.
Results: Accuracy of diagnostic mandibular invasion by CBCT was 93.4% (95%CI, 85.3 - 97.8%).
Sensitivity and specificity of surgical team were 80% and 98.2%, sensitivity and specificity of
radiologist were 90% and 94.6%, comparison between radiologist and surgical team results were
P-value 0.125 and Kappa 0.860. Preoperative CBCT within 7 days, accuracy was 95.8% (95%CI, 88.1 –
99.1%). Two patients (2.6%) shows the surgical plan was changed after evaluated with preoperative
CBCT from marginal mandibulectomy to segmental mandibulectomy.
Conclusion: Preoperative CBCT is highly accurate for evaluate mandibular invasion of oral SCCA and
duration within 7 days help improve diagnostic accuracy. For practical, the surgical team can used
CBCT and interpreted by themselves. However, CBCT does not change surgical plan significantly.
Keywords: Cone-beam computed tomography, Mandibular invasion, Oral squamous cell
carcinoma.
Article Details
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ต้นฉบับที่ส่งมาพิจารณายังวารสารหู คอ จมูก และใบหน้า จะต้องไม่อยู่ในการพิจารณาของวารสารอื่น ในขณะเดียวกันต้นฉบับที่จะส่งมาจะผ่านการอ่านโดยผู้ทรงคุณวุฒิ หากมีการวิจารณ์หรือแก้ไขจะส่งกลับไปให้ผู้เขียนตรวจสอบแก้ไขอีกครั้ง ต้นฉบับที่ผ่านการพิจารณาให้ลงตีพิมพ์ถือเป็นสมบัติของวารสารหู คอ จมูกและใบหน้า ไม่อาจนำไปลงตีพิมพ์ที่อื่นโดยไม่ได้รับอนุญาต
ตารางแผนภูมิ รูปภาพ หรือข้อความเกิน 100 คำที่คัดลอกมาจากบทความของผู้อื่น จะต้องมีใบยินยอมจากผู้เขียนหรือผู้ทรงลิขสิทธิ์นั้นๆ และใหร้ะบุกำกับไว้ในเนื้อเรื่องด้วย
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