Accuracy of Magnetic Resonance Imaging in Detecting Depth of Invasion of Oral Squamous Cell Carcinoma

Abstract

INTRODUCTION: Depth of Invasion (DOI) is a key prognostic factor for Oral Squamous Cell Carcinoma (OSCC), impacting surgical decisions. The research aims to evaluate the accuracy of Magnetic resonance imaging (MRI) in assessing DOI, comparing it with histopathological findings and also to determine the MRI-determined DOI cut-off value for predicting neck lymph node metastasis.

MATERIALS AND METHODS:  It is a hospital based cross sectional study conducted over 18 months at Sri Manakula Vinayagar Medical College, Puducherry. The depth of invasion was measured in 70 patients who underwent MRI for preoperative evaluation of oral cavity cancers and was correlated with postoperative histopathological findings. The MRI-derived DOI was compared to the postoperative histopathological DOI to assess accuracy. The study also examined the relationship between MRI-derived DOI and cervical lymph node metastasis using a receiver operating characteristic (ROC) curve, with data analysis performed in SPSS 24.

RESULTS: The mean age of presentation was found to be around 57 years of age with male predominance. The most common site of involvement was buccal mucosa. Tumour's DOI was well correlated between MRI measurement and pathology with correlation coefficients of 0.94. MRI-derived DOI was 1.41 mm (10.7%) larger than pathology. The accuracy of MRI in deciding pathological DOI was 67.9%. The cut-off value of MRI-derived DOI was 8mm for predicting lymph node metastasis.

CONCLUSION: Utilizing MRI for preoperative DOI estimation enhances staging accuracy in oral cavity cancers, showing strong correlation with pathology. Despite MRI measuring DOI 10.7% larger than pathology, it's essential for preoperative staging.