Diagnostic Accuracy of Multiple Detector Computed Tomography in Detecting Mandibular Invasion in Oral Squamous Cell Carcinoma

Abstract

The prediction of bony involvement of the mandible in oral Squamous Cell Carcinoma (SCC) by taking imaging scans prior to surgery is an important issue. The objective of our study was to determine the diagnostic accuracy of Multiple Detector Computed Tomography (MDCT) in detecting mandibular involvement in oral SCC, using histopathology which is considered the gold standard in this field. A cross-sectional validation study was conducted in the Department of Radiology, Abbasi Shaheed Hospital (Karachi, Pakistan), from July 2017 to June 2018. Nonprobability consecutive sampling was used to select 75 patients with oral SCC who were referred to the Department of Radiology. MDCT was performed, and lesions were assessed for detection of mandibular invasion and confirmed by histopathology. Diagnostic validation [sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of MDCT] was carried out using histopathology. Data were analyzed using SPSS version 21.0 (SPSS Inc., IBM Corp., Armonk, NY, USA). Overall, 65.3% (49) of participants were males, whereas 34.7% (26) were females. MDCT correctly diagnosed 46 of 48 cases with mandibular involvement and correctly excluded mandibular invasion in 26 of 27 cases without invasion. The sensitivity and specificity of MDCT for detecting mandibular involvement were 95.83% and 96.42%, respectively, and the PPV and NPV of MDCT were 97.87% and 92.85%, respectively. Thus, MDCT proved to be a sound modality in early diagnosis of mandibular involvement in oral cavity SCC, paving the path for early detection and treatment.