F J B Slieker1, J T M Van Gemert1, M Ghafoori Seydani2, S Farsai2, G E Breimer3, T Forouzanfar4, R de Bree5, A J W P Rosenberg6, E M Van Cann7. 1. Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 2. Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands. 3. Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands. 4. Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands. 5. Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. 6. Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 7. Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: e.m.vancann@umcutrecht.nl.
Abstract
OBJECTIVE: To determine the diagnostic value of cone beam computed tomography (CBCT) in detecting bone invasion in maxillary squamous cell carcinoma (MSCC). STUDY DESIGN: In this retrospective cohort study, preoperative CBCT scans were independently assessed by a single surgeon in imaging assessment 1 (IA 1) and by 1 surgeon with 2 dentists in consensus (IA 2) for the presence of bone invasion in MSCC. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, area under the receiver operating characteristic curve (AUC), and Cohen's κ were calculated. Histopathologic results of resection specimens served as the reference standard. RESULTS: Of 27 patients, 19 (70%) had proven bone invasion. IA 1 yielded 68.4% sensitivity, 75.0% specificity, 86.7% PPV, 50.0% NPV, 70.4% accuracy, and 0.717 AUC. All results of IA 2 were true-positive and true-negative, resulting in 100% sensitivity, specificity, PPV, NPV, accuracy, and AUC. The assessments differed in 6 cases. Interobserver κ was fair (0.38, 95% CI 0.04-0.72, P = .038). There was a significant association between CBCT detection of bone invasion and extent of surgical treatment (P = .006) CONCLUSIONS: The diagnostic accuracy of CBCT was high but observer-dependent. CBCT examination may be useful in surgical treatment planning.
OBJECTIVE: To determine the diagnostic value of cone beam computed tomography (CBCT) in detecting bone invasion in maxillary squamous cell carcinoma (MSCC). STUDY DESIGN: In this retrospective cohort study, preoperative CBCT scans were independently assessed by a single surgeon in imaging assessment 1 (IA 1) and by 1 surgeon with 2 dentists in consensus (IA 2) for the presence of bone invasion in MSCC. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, area under the receiver operating characteristic curve (AUC), and Cohen's κ were calculated. Histopathologic results of resection specimens served as the reference standard. RESULTS: Of 27 patients, 19 (70%) had proven bone invasion. IA 1 yielded 68.4% sensitivity, 75.0% specificity, 86.7% PPV, 50.0% NPV, 70.4% accuracy, and 0.717 AUC. All results of IA 2 were true-positive and true-negative, resulting in 100% sensitivity, specificity, PPV, NPV, accuracy, and AUC. The assessments differed in 6 cases. Interobserver κ was fair (0.38, 95% CI 0.04-0.72, P = .038). There was a significant association between CBCT detection of bone invasion and extent of surgical treatment (P = .006) CONCLUSIONS: The diagnostic accuracy of CBCT was high but observer-dependent. CBCT examination may be useful in surgical treatment planning.