Irradiated carcinoma of the tongue: correlation of MR imaging findings with pathology.

Abstract

OBJECTIVE:

MR imaging was prospectively correlated with pathologic findings to study whether MR imaging can differentiate viable from nonviable tumor tissue in the irradiated carcinoma of the tongue.

SUBJECTS AND METHODS:

MR examinations were performed after radiation therapy in 21 patients with carcinoma of the tongue. All patients underwent either a total glossectomy or hemiglossectomy after radiation therapy. Specimens were examined microscopically. Radiation changes were histologically graded into four groups (I, minimal cellular changes; II, presence of cellular changes and partial destruction of the tumor; III, only nonviable tumor cells; IV, no tumor cells). MR examinations included T2-weighted imaging, unenhanced T1-weighted imaging, dynamic contrast-enhanced imaging, and contrast-enhanced T1-weighted imaging.

RESULTS:

On unenhanced T1-weighted images, the lesion was hypointense, except for two patients with histologic grade III. On T2-weighted images, the lesion appeared hyperintense in 12 of 14 patients with viable tumor cells (grades I and II); however, the lesion was hypointense in four, and isointense in two of seven patients with nonviable tumor cells (grades III or IV). Contrast-enhanced T1-weighted images showed that the degree of contrast enhancement of the lesion was equal to or lower than that of a normal salivary gland in 18 of 21 patients. For the time of maximal enhancement of the lesion on dynamic imaging, there was no substantial difference between viable (grades I and II) and nonviable (grades III and IV) tumor tissue.

CONCLUSION:

The present study shows that T2-weighted imaging is feasible for differentiating viable from nonviable tumor tissue in irradiated carcinoma of the tongue.

• Authors: Noriaki Tomura, Osamu Watanabe, Koki Kato, Satoshi Takahashi, Jiro Watarai, Masato Sageshima, Michinori Yokomizo
• Journal: AJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 178 Issue 3 Pg. 705-10 (Mar 2002) ISSN: 0361-803X [Print] United States
• PMID: 11856702 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Gadolinium DTPA

Topics

• Aged
• Carcinoma, Squamous Cell (diagnosis, pathology, radiotherapy)
• Contrast Media
• Female
• Gadolinium DTPA
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neoplasm Staging
• Tongue (pathology, radiation effects)
• Tongue Neoplasms (diagnosis, pathology, radiotherapy)