Utility of imaging techniques in the diagnosis of oral cancer

Abstract

Purpose: Imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) are often used to complement the clinical exploration and staging of oral squamous cell carcinoma (OSCC). Which of these techniques is best in establishing correct staging and treatment planning is not clear, however. This study aims to determine which technique is most appropriate for diagnosing the primary tumor and for detecting bone invasion and neck metastases.

Material and methods: A Medline literature search was made over the last 10 years. In each selected study, we recorded the sample size and sensitivity, specificity and precision. Strengths and limitations of each study were assessed also.

Results: Eight articles relating to detection of the primary tumor, 19 to bone invasion, and 28 to neck metastases were selected and compared.

Conclusion: Despite the high precision of positron emission tomography (PET) or hybrid techniques in detecting the primary tumor, they have not replaced magnetic resonance imaging (MRI) or computed tomography (CT), particularly in the case of small lesions. MRI and CT are adequate techniques in the assessment of bone invasion.Recent studies have shown good results with PET-CT and cone-beam CT, but future studies are needed to demonstrate their benefits. Despite the high precision of PET and PET-CT, their use in assessing neck metastases remains subject to controversy, and their use in all patients with OSCC is not justified. CT and MRI are useful in determining the N category.

Keywords: Computed tomography; Diagnosis; Magnetic resonance imaging; Oral cancer; Positron emission tomography.