Squamous cell carcinomas that arise in the oral cavity and tongue base: can CT help predict perineural or vascular invasion?

Abstract

To determine the ability to use computed tomography (CT) to predict invasion of adjacent nerves or vessels by oral cavity tumors. Contrast material-enhanced CT scans and histopathologic reports were retrospectively reviewed in 48 patients (36 men, 12 women) aged 38-75 years who underwent gross total resection of squamous cell carcinomas arising in the tongue, the base of the tongue, and the floor of the mouth. CT criteria for diagnosis of perineural or vascular invasion were aggressive tumor margins, invasion of the sublingual space, and direct adjacency of the tumor to the enhanced lingual vasculature in the sublingual space. CT and histopathologic findings of perineural and/or vascular invasion by tumor were correlated in all patients. With the above criteria, CT findings predictive of perineural or vascular invasion had a sensitivity of 88%; specificity, 83%; positive predictive value, 85%; and negative predictive value, 84%. CT findings can be used to predict perineural or vascular invasion by oral cavity tumors.