Comparison of CT, MRI, and PET/CT for the evaluation bone invasion in upper and lower gingival cancers

Publication date: Available online 22 December 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Young Chan Lee, Ah Ra Jung, Oh Eun Kwon, Eui-Jong Kim, Il Ki Hong, Jung-Woo Lee, Young-Gyu Eun

Abstract

Purpose

Preoperative detection of bone invasion is important in cases of gingival cancer. The aim of this study was to compare the diagnostic value of three imaging methods for the detection of bone invasion in upper and lower gingival cancer: computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT.

Material and methods

This retrospective cohort study enrolled patients who had undergone a maxillectomy or mandibulectomy for gingival cancer. Each preoperative image (CT, MRI, or PET/CT) was reviewed for the presence of bone invasion, and the possibility for bone invasion was graded. These results were verified with pathology reports. Sensitivity, specificity, positive predictive value, and negative predictive value for the detection of mandibular involvement in alveolar bone were calculated, and a receiver operating characteristic (ROC) curve analysis was performed.

Results

Forty patients (27 men and 13 women) were enrolled. Pathologic examination revealed bone invasion in 25 of the 40 patients. Among them, 13 patients had maxillary and 12 had mandibular alveolus involvement. The diagnostic accuracy of CT (90.0%) was highest among the three modalities for the detection of bone invasion. In the ROC curve analysis, the area-under-the-curve values in upper gingival cancer were lower than those for lower gingival cancer.

Conclusion

The three imaging methods were less sensitive for the detection of bone invasion in upper gingival cancer than in lower gingival cancer. Cases of upper gingival cancer should be evaluated more carefully for bone invasion before surgery.

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