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PET with contrast-enhanced CT: its usefulness in head and neck malignancy
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Poster Presentations / British Journal of Oral and Maxillofacial Surgery 50S (2012) S42–S66
study with a larger sample size is needed to show its benefit in head and neck imaging. http://dx.doi.org/10.1016/j.bjoms.2012.04.088 P10 PET with contrast-enhanced CT: its usefulness in head and neck malignancy H. Cottom ∗ , S. Bakhtiari, P. Ameerally Northampton General Hospital, United Kingdom Objective: Radiographic imaging plays an important role in facilitating clinical examination in head and neck cancer. PET-CT has been shown to further improve accurate localisation of primary head and neck neoplasms, the diagnosis of residual/recurrent disease, and may have potential in the detection of occult primaries. The objective was therefore to evaluate PET-CT in these aspects of head and neck malignancy. Method: The Northampton General Hospital PET-CT database was searched for all patients receiving a PETCT scan in relation to a known/suspected head and neck malignancy. The time period of inclusion was September 2009–October 2010. Notes for an identified 60 patients were retrieved with radiographic reports for retrospective analysis. Ethical approval was not required as information was kept entirely confidential, ensuring anonymity. Results: Of the occult primaries PET-CT correctly located the primary site in 5 patients (18.5%). In staging PET-CT appeared most beneficial in providing information on the presence/extent of distant metastatic disease, since in 1/3rd of cases there had been an underestimation by conventional radiography. In 75% PET-CT successfully identified locoregional recurrence, having 1 false-negative result. Conclusion: PET-CT was found to be accurate in surveillance and staging of head and neck cancer, particularly in relation to nodal and distant metastatic disease. In the detection of occult head and neck primaries a lower success rate was found (18.5%) compared to previous studies with falsepositives occurring in 33.3%. Nevertheless PET-CT should remain an important supplement especially in guiding biopsy, but may not be as effective as originally believed. http://dx.doi.org/10.1016/j.bjoms.2012.04.089 P11 Accuracy of MRI in prediction of tumour thickness and nodal stage in oral carcinoma
Disease recurs more commonly in patients with histopathologically invaded nodes.2 Tumour thickness is important in helping to predict local recurrence, nodal metastases and patient survival. An accurate preoperative assessment of tumour thickness is desirable for optimal treatment planning. Aim: To evaluate the correlation and accuracy of MRI measured depth of invasion and histological tumour thickness for various sub sites of oral SCC and determine its predictive accuracy for nodal metastases. Methods: A prospective review of 50 patients (34 males/16 females) with an average age of 66 years (range 38–89) who underwent primary surgery for an oral squamous cell carcinoma. MRI STIR sequence in axial plane and T2 weighted images in coronal plane were used to measure tumour thickness, size and nodal status. These were correlated with histological findings. Results: Significant correlation (p < 0.001) was found between MR measured and histological tumour thickness. Greatest correlation was observed for lateral tongue and least for floor of mouth. Sensitivity of MR at detecting nodal disease was 92% and specificity 84%. Positive predictive value of MRI at predicting nodal metastasis was 76%. 5 patients had pathological Extra Capsular Spread which was not detected on MRI. Conclusion: MRI measured tumour thickness has similar predictability for nodal metastases as histological thickness. Tongue SCC is most accurate and floor of mouth least. MRI tumour thickness is a poor predictor of ECS. Additional pre operative assessment of tumour thickness, using Ultrasound scan may be indicated for certain tumour sites and stages.
References 1. Myers EN, Fagan JJ. Treatment of the N+ neck in squamous cell carcinoma of the upper aerodigestive tract. Otolaryngol Clin North Am 1998;31:671–86. 2. Alvi A, Johnson JT. Extracapsular spread in the clinically negative neck (N0): implications and outcome. Otolaryngol Head Neck Surg 1996;114:65–70.
http://dx.doi.org/10.1016/j.bjoms.2012.04.090 P12 Application of the Oral Health Impact Profile-14 in Norwegian adults following third molar surgery. A pilot study E.C. Vigen ∗ , O. Egeland, G. Lyngstad, A. Skoglund, P. Skjelbred, L.A. Skoglund
L. Dunphy ∗ , V. Sood, W.S. Hislop
Section of Dental Pharmacology and Pharmacotherapy, University of Oslo, Norway
Crosshouse Hospital, Kilmarnock, United Kingdom
Introduction: The intensity of inflammatory symptoms (e.g. pain and swelling) is used to assess the postoperative status of patients following oral surgical procedures. The Oral Health Impact Profile 14 (OHIP) measures patients’ perceptions of the social impact of the oral disorders on their well-being.
Introduction: The presence or absence of lymph node metastases is the most important prognostic factor in patients with squamous cell carcinoma (SCC) of the head and neck.1
Poster Presentations / British Journal of Oral and Maxillofacial Surgery 50S (2012) S42–S66
study with a larger sample size is needed to show its benefit in head and neck imaging. http://dx.doi.org/10.1016/j.bjoms.2012.04.088 P10 PET with contrast-enhanced CT: its usefulness in head and neck malignancy H. Cottom ∗ , S. Bakhtiari, P. Ameerally Northampton General Hospital, United Kingdom Objective: Radiographic imaging plays an important role in facilitating clinical examination in head and neck cancer. PET-CT has been shown to further improve accurate localisation of primary head and neck neoplasms, the diagnosis of residual/recurrent disease, and may have potential in the detection of occult primaries. The objective was therefore to evaluate PET-CT in these aspects of head and neck malignancy. Method: The Northampton General Hospital PET-CT database was searched for all patients receiving a PETCT scan in relation to a known/suspected head and neck malignancy. The time period of inclusion was September 2009–October 2010. Notes for an identified 60 patients were retrieved with radiographic reports for retrospective analysis. Ethical approval was not required as information was kept entirely confidential, ensuring anonymity. Results: Of the occult primaries PET-CT correctly located the primary site in 5 patients (18.5%). In staging PET-CT appeared most beneficial in providing information on the presence/extent of distant metastatic disease, since in 1/3rd of cases there had been an underestimation by conventional radiography. In 75% PET-CT successfully identified locoregional recurrence, having 1 false-negative result. Conclusion: PET-CT was found to be accurate in surveillance and staging of head and neck cancer, particularly in relation to nodal and distant metastatic disease. In the detection of occult head and neck primaries a lower success rate was found (18.5%) compared to previous studies with falsepositives occurring in 33.3%. Nevertheless PET-CT should remain an important supplement especially in guiding biopsy, but may not be as effective as originally believed. http://dx.doi.org/10.1016/j.bjoms.2012.04.089 P11 Accuracy of MRI in prediction of tumour thickness and nodal stage in oral carcinoma
Disease recurs more commonly in patients with histopathologically invaded nodes.2 Tumour thickness is important in helping to predict local recurrence, nodal metastases and patient survival. An accurate preoperative assessment of tumour thickness is desirable for optimal treatment planning. Aim: To evaluate the correlation and accuracy of MRI measured depth of invasion and histological tumour thickness for various sub sites of oral SCC and determine its predictive accuracy for nodal metastases. Methods: A prospective review of 50 patients (34 males/16 females) with an average age of 66 years (range 38–89) who underwent primary surgery for an oral squamous cell carcinoma. MRI STIR sequence in axial plane and T2 weighted images in coronal plane were used to measure tumour thickness, size and nodal status. These were correlated with histological findings. Results: Significant correlation (p < 0.001) was found between MR measured and histological tumour thickness. Greatest correlation was observed for lateral tongue and least for floor of mouth. Sensitivity of MR at detecting nodal disease was 92% and specificity 84%. Positive predictive value of MRI at predicting nodal metastasis was 76%. 5 patients had pathological Extra Capsular Spread which was not detected on MRI. Conclusion: MRI measured tumour thickness has similar predictability for nodal metastases as histological thickness. Tongue SCC is most accurate and floor of mouth least. MRI tumour thickness is a poor predictor of ECS. Additional pre operative assessment of tumour thickness, using Ultrasound scan may be indicated for certain tumour sites and stages.
References 1. Myers EN, Fagan JJ. Treatment of the N+ neck in squamous cell carcinoma of the upper aerodigestive tract. Otolaryngol Clin North Am 1998;31:671–86. 2. Alvi A, Johnson JT. Extracapsular spread in the clinically negative neck (N0): implications and outcome. Otolaryngol Head Neck Surg 1996;114:65–70.
http://dx.doi.org/10.1016/j.bjoms.2012.04.090 P12 Application of the Oral Health Impact Profile-14 in Norwegian adults following third molar surgery. A pilot study E.C. Vigen ∗ , O. Egeland, G. Lyngstad, A. Skoglund, P. Skjelbred, L.A. Skoglund
L. Dunphy ∗ , V. Sood, W.S. Hislop
Section of Dental Pharmacology and Pharmacotherapy, University of Oslo, Norway
Crosshouse Hospital, Kilmarnock, United Kingdom
Introduction: The intensity of inflammatory symptoms (e.g. pain and swelling) is used to assess the postoperative status of patients following oral surgical procedures. The Oral Health Impact Profile 14 (OHIP) measures patients’ perceptions of the social impact of the oral disorders on their well-being.
Introduction: The presence or absence of lymph node metastases is the most important prognostic factor in patients with squamous cell carcinoma (SCC) of the head and neck.1