Assessment of surgical tumor‐free resection margins in fresh squamous‐cell carcinoma resection specimens of the tongue using a clinical MRI system
Jan Heidkamp, Willem L. J. Weijs, Adriana C. H. van Engen–van Grunsven, Ilse de Laak‐de Vries, Marnix C. Maas, Maroeska M. Rovers, Jurgen J. Fütterer, Stefan C. A. Steens, Robert P. Takes
Abstract
BACKGROUND: Current intraoperative methods of visual inspection and tissue palpation by the surgeon, and frozen section analysis cannot reliably prevent inadequate surgical margins in patients treated for oral squamous-cell carcinoma (OSCC). This study assessed feasibility of MRI for the assessment of surgical resection margins in fresh OSCC specimens. METHODS: Ten consecutive tongue specimens containing OSCC were scanned using 3 T clinical whole-body MRI. Two radiologists independently annotated OSCC location and minimal tumor-free margins. Whole-mount histology was the reference standard. RESULTS: The positive predictive values (PPV) and negative predictive values (NPV) for OSCC localization were 96% and 75%, and 87% and 79% for reader 1 and 2, respectively. The PPV and NPV for identification of margins <5 mm were 38% and 91%, and 5% and 87% for reader 1 and 2, respectively. CONCLUSIONS: MRI accurately localized OSCC with high inter-reader agreement in fresh OSCC specimens, but it seemed not yet feasible to accurately assess the surgical margin status.