Imaging tests find bone metastasis in oral cancers

Most imaging modalities are diagnostically accurate in detecting mandibular bone tissue invasion in patients with oral squamous cell carcinoma (SCC), according to a study in Dentomaxillofacial Radiology (June 2013, Vol. 42:6).

Researchers from Universidad Austral de Chile conducted a systematic review of studies in Medline, SciELO, and ScienceDirect, published between 1960 and 2012 in English, Spanish, or German, that compared detection of mandibular bone tissue invasion via different imaging tests against a histopathology reference standard. Sensitivity and specificity data were extracted from each study; the outcome measure was diagnostic accuracy.

They found 338 articles, of which only five met the inclusion criteria. Tests included were computed tomography (CT) (four articles), MRI (four articles), panoramic radiography (one article), positron emission tomography (PET)/CT (one article), and cone-beam CT (CBCT) (one article).

The quality of articles was low to moderate, the researchers noted, but the evidence showed that all tests have a high diagnostic accuracy for detecting mandibular bone tissue invasion by SCC, with sensitivity values of 94% (MRI), 91% (cone-beam CT), 83% (CT), and 55% (panoramic radiography), and specificity values of 100% (CT, MRI, CBCT), 97% (PET/CT), and 91.7% (panoramic radiography).

While available evidence is "scarce," the researchers concluded, "it is consistently shown that current imaging methods give a moderate to high diagnostic accuracy for the detection of mandibular bone tissue invasion by SCC."

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