Bibliographic Details
| Title: |
Value of radiological depth of invasion in non-pT4 Oral tongue squamous cell carcinoma: implication for preoperative MR T-staging. |
| Authors: |
Huang, Wenjie, Zhang, Yu, Fu, Gui, Huang, Manqian, Luo, Guangfeng, Xie, Hui, Liang, Zhiying, Cao, Di, Li, Shuqi, Luo, Chao, Li, Haojiang, Gao, Jiexin, Nie, Rongcheng, Ruan, Guangying, Li, Hao, Liu, Lizhi |
| Source: |
European Radiology; Sep2024, Vol. 34 Issue 9, p6047-6059, 13p |
| Subject Terms: |
MAGNETIC resonance imaging, SQUAMOUS cell carcinoma, DETECTION limit, INTRACLASS correlation, MULTIVARIATE analysis |
| Abstract: |
Objective: The prognostic stratification for oral tongue squamous cell carcinoma (OTSCC) is heavily based on postoperative pathological depth of invasion (pDOI). This study aims to propose a preoperative MR T-staging system based on tumor size for non-pT4 OTSCC. Methods: Retrospectively, 280 patients with biopsy-confirmed, non-metastatic, pT1-3 OTSCC, treated between January 2010 and December 2017, were evaluated. Multiple MR sequences, including axial T2-weighted imaging (WI), unenhanced T1WI, and axial, fat-suppressed coronal, and sagittal contrast-enhanced (CE) T1WI, were utilized to measure radiological depth of invasion (rDOI), tumor thickness, and largest diameter. Intra-class correlation (ICC) and univariate and multivariate analyses were used to evaluate measurement reproducibility, and factors' significance, respectively. Cutoff values were established using an exhaustive method. Results: Intra-observer (ICC = 0.81–0.94) and inter-observer (ICC = 0.79–0.90) reliability were excellent for rDOI measurements, and all measurements were significantly associated with overall survival (OS) (all p <.001). Measuring the rDOI on axial CE-T1WI with cutoffs of 8 mm and 12 mm yielded an optimal MR T-staging system for rT1-3 disease (5-year OS of rT1 vs rT2 vs rT3: 94.0% vs 72.8% vs 57.5%). Using multivariate analyses, the proposed T-staging exhibited increasingly worse OS (hazard ratio of rT2 and rT3 versus rT1, 3.56 [1.35–9.6], p =.011; 4.33 [1.59–11.74], p =.004; respectively), which outperformed pathological T-staging based on nonoverlapping Kaplan–Meier curves and improved C-index (0.682 vs. 0.639, p <.001). Conclusions: rDOI is a critical predictor of OTSCC mortality and facilitates preoperative prognostic stratification, which should be considered in future oral subsite MR T-staging. Clinical relevance statement: Utilizing axial CE-T1WI, an MR T-staging system for non-pT4 OTSCC was developed by employing rDOI measurement with optimal thresholds of 8 mm and 12 mm, which is comparable with pathological staging and merits consideration in future preoperative oral subsite planning. Key Points: • Tumor morphology, measuring sequences, and observers could impact MR-derived measurements and compromise the consistency with histology. • MR-derived measurements, including radiological depth of invasion (rDOI), tumor thickness, and largest diameter, have a prognostic impact on OS (all p <.001). • rDOI with cutoffs of 8 mm and 12 mm on axial CE-T1WI is an optimal predictor of OS and could facilitate risk stratification in non-pT4 OTSCC disease. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
