Diagnostic Accuracy of Computed Tomography in Detecting Bone Invasion due to Squamous Cell Carcinoma of Buccal Mucosa.

OBJECTIVE: To determine the diagnostic accuracy of contrast enhanced computed tomography (CECT) of head and neck in detecting adjacent bone invasion due to squamous cell carcinoma of buccal mucosa using histopathology as gold standard.

STUDY DESIGN: Cross sectional / descriptive study.

PLACE AND DURATION OF STUDY: Department of Radiology, Dow Medical College, Civil Hospital, Karachi, from September 2015 to October 2016.

METHODOLOGY: A total of 116 patients clinically suspected of oral cavity squamous cell carcinoma (OCSCC) involving buccal mucosa was included. After taking proper history, all these patients referred to Radiology Department for contrast enhanced contiguous thin slice sections of 3-5 mm the primary site of the lesion prior to surgery. Reconstruction of all images done by using bone algorithm. The diagnostic accuracy of CECT was analysed against the gold standard of histopathology. Statistical analyses were carried out by using SPSS 21. Mean ±SD were calculated for quantitative variable like age. For qualitative variables, frequencies and percentages were calculated. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were computed for CECT, taking histopathology as gold standard.

RESULTS: Eighty-three male (71%) and 33 female (28%) patients. Mean age was 46.66±10.77 years. Mean duration of sign and symptoms was 3.47 ±1.54 months. Sensitivity, specificity, PPV, NPV and accuracy were 69.2%, 78.4%, and 80.4%, 66.7% and 73.3%, respectively.

CONCLUSION: CECT is a reliable technique for detecting adjacent bone invasion due to squamous cell carcinoma of buccal mucosa by using 3-5 mm thin-section CT reconstructed with bone algorithm.