Abstract：
OBJECTIVE: The 8th edition of the American Joint Committee on Cancer staging system included the depth of invasion (DOI) for the T classification of oral cancer. However, no standardized method has been established to clinically measure the DOI. This study aimed to investigate the accuracy of MRI-based DOI for oral tongue squamous cell carcinoma (OTSCC) in each MRI sequence.
METHODS: We enrolled 49 patients with histologically proven OTSCC, treated surgically between April 2017 and February 2021. We divided the DOI into three groups using 5 and 10 mm, the thresholds for determining the T stage, and retrospectively evaluated the agreement between MRI-based DOI and pathological DOI (pDOI) for each MRI sequence, axial T1-weighted imaging (T1WI), T2-weighted imaging with fat suppression (FS-T2WI), contrast-enhanced T1WI with fat suppression (CE-T1WI), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) maps. We also divided the DOI into two groups using 3 mm, the threshold for considering elective neck dissection, and evaluated the overestimation rate of MRI-based DOI in lesions with pDOI ≤ 3 mm.
RESULTS: With 5-mm and 10-mm divisions, the accuracy of the DOI assessment was highest on DWI (0.82, weighted kappa = 0.85). With a 3-mm division, the accuracy was also highest on DWI (0.87, kappa = 0.73). The overestimation rate of the MRI-based DOI in lesions with pDOI ≤ 3 mm was lowest on DWI (27.8%).
CONCLUSIONS: DOI on DWI exhibits a comparatively higher rate of concordance with pDOI. DWI may be more useful than other MRI sequences in evaluating the DOI of OTSCC.
METHODS: We enrolled 49 patients with histologically proven OTSCC, treated surgically between April 2017 and February 2021. We divided the DOI into three groups using 5 and 10 mm, the thresholds for determining the T stage, and retrospectively evaluated the agreement between MRI-based DOI and pathological DOI (pDOI) for each MRI sequence, axial T1-weighted imaging (T1WI), T2-weighted imaging with fat suppression (FS-T2WI), contrast-enhanced T1WI with fat suppression (CE-T1WI), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) maps. We also divided the DOI into two groups using 3 mm, the threshold for considering elective neck dissection, and evaluated the overestimation rate of MRI-based DOI in lesions with pDOI ≤ 3 mm.
RESULTS: With 5-mm and 10-mm divisions, the accuracy of the DOI assessment was highest on DWI (0.82, weighted kappa = 0.85). With a 3-mm division, the accuracy was also highest on DWI (0.87, kappa = 0.73). The overestimation rate of the MRI-based DOI in lesions with pDOI ≤ 3 mm was lowest on DWI (27.8%).
CONCLUSIONS: DOI on DWI exhibits a comparatively higher rate of concordance with pDOI. DWI may be more useful than other MRI sequences in evaluating the DOI of OTSCC.
摘要：
目的：美国癌症联合委员会第8版分期系统包括用于口腔癌T分类的浸润深度（DOI）。然而,尚未建立临床测量DOI的标准化方法。本研究旨在探讨基于MRI的DOI在口腔舌鳞状细胞癌（OTSCC）各MRI序列中的准确性。
方法：我们招募了49例经组织学证实的OTSCC患者，在2017年4月至2021年2月期间接受手术治疗。我们使用5和10毫米将DOI分为三组，用于确定T阶段的阈值，并回顾性评估每个MRI序列的基于MRI的DOI与病理DOI（pDOI）之间的一致性，轴向T1加权成像（T1WI），T2加权成像与脂肪抑制（FS-T2WI），对比增强的T1WI与脂肪抑制（CE-T1WI），弥散加权成像(DWI),和表观扩散系数(ADC)图。我们还使用3毫米将DOI分为两组，考虑选择性颈清扫术的门槛，并评估了pDOI≤3mm的病变中基于MRI的DOI的高估率。
结果：用5毫米和10毫米分割，在DWI上,DOI评估的准确性最高(0.82,加权kappa=0.85).用3毫米的分割，DWI的准确度也最高(0.87,kappa=0.73).在DWI上，pDOI≤3mm的病变中基于MRI的DOI的高估率最低（27.8％）。
结论：DWI上的DOI与pDOI的一致性相对较高。DWI在评估OTSCC的DOI方面可能比其他MRI序列更有用。
方法：我们招募了49例经组织学证实的OTSCC患者，在2017年4月至2021年2月期间接受手术治疗。我们使用5和10毫米将DOI分为三组，用于确定T阶段的阈值，并回顾性评估每个MRI序列的基于MRI的DOI与病理DOI（pDOI）之间的一致性，轴向T1加权成像（T1WI），T2加权成像与脂肪抑制（FS-T2WI），对比增强的T1WI与脂肪抑制（CE-T1WI），弥散加权成像(DWI),和表观扩散系数(ADC)图。我们还使用3毫米将DOI分为两组，考虑选择性颈清扫术的门槛，并评估了pDOI≤3mm的病变中基于MRI的DOI的高估率。
结果：用5毫米和10毫米分割，在DWI上,DOI评估的准确性最高(0.82,加权kappa=0.85).用3毫米的分割，DWI的准确度也最高(0.87,kappa=0.73).在DWI上，pDOI≤3mm的病变中基于MRI的DOI的高估率最低（27.8％）。
结论：DWI上的DOI与pDOI的一致性相对较高。DWI在评估OTSCC的DOI方面可能比其他MRI序列更有用。
