Abstract
Objective: Comparing the Accuracy of computed tomography (CT) and 99mTc-methylene-diphosphonate (MDP) SPECT/CT fusion imaging in determining the extent of mandibular invasion by squamous cell carcinoma of the oral cavity, to study the clinical value of SPECT/CT fusion imaging in evaluating the extent of mandibular invasion by squamous cell carcinoma of oral cavity. Material and Methods: Fifty-one patients were revealed mandibular invasion by moderately differentiated squamous cell carcinoma of the oral cavity underwent CT and SPECT/CT. The patients were divided into two groups: A group (oral mucosal squamous cell carcinoma) and B group (primary intra-osseous carcinoma). Two radiologists assessed the CT images and two nuclear medicine physicians separately assessed the SPECT/CT images in consensus and without knowledge of the results of other imaging tests. The extent of bone involvement suggested with an imaging modality was compared with pathological findings in the surgical specimen. Results: The pathological findings as the reference standard ,group A:the extent of mandibular invasion by moderately differentiated squamous cell carcinoma underwent SPECT/CT was 1.02±0.20cm lager than the pathological examination identified, and the extent of mandibular invasion underwent CT was Advances in Cancer: Research & Treatment 2 1.42±0.35cm smaller than the pathological examination identified. There were statistically significant differences among the three methods, p<0.01. Group B: the extent of mandibular invasion by moderately differentiated squamous cell carcinoma underwent SPECT/CT was 1.3±0.39cm larger than that underwent pathological examination. The extent of mandibular invasion underwent CT was 2.55±1.44cm smaller than the pathological examination identified. There were statistically significant difference among the three methods (p<0.01), too. Conclusion: SPECT/CT fusion imaging in identifying the extent of squamous cell carcinoma of the oral cavity on mandibular invasion has important clinical value. The extent of mandibular invasion underwent SPECT/CT was the extent which surgeon to reach the clear margins to the limits of resection.
Highlights
It well is recognized and documented that malignant tumor of oral cavity invading mandibular bone require partial or total mandibulectomy in order to provide adequate margins
SPECT/coregistration of structural (CT) fusion imaging in identifying the extent of squamous cell carcinoma of the oral cavity on mandibular invasion has important clinical value
The extent of mandibular invasion underwent SPECT/CT was the extent which surgeon to reach the clear margins to the limits of resection
Summary
It well is recognized and documented that malignant tumor of oral cavity invading mandibular bone require partial or total mandibulectomy in order to provide adequate margins. Preoperative assessment the extent of mandibular invasion by malignant tumor is very important to ensure getting a safe tissue margin, Gu, D.H. et al (2010) thought it could reserve most well-being bone tissue, and it is significance to patien’s prognosis. (2011) hought SPECT (Single photon emission computed tomography) was functional imaging modality, high sensitivity, but lack the structural delineation. (2011) thought CT (Computered Tomography) was anatomical imaging modality, provides accurate morphological information necessary for tumor localization and detection of structural abnormalities, but can not reflect the functional or metabolic activity of the tumor. Goerres, G.W. et al (2005) mentioned the coregistration of structural (CT) and functional (SPECT) imaging information can improve the identification of bone invasion. The value of SPECT/CT to determine the extent of malignant tumour invading mandibule had not be reported
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