When should MRI be Recommended for the Accurate Clinical Staging of Base of Tongue Carcinoma?


Background and Purpose: According to the American Joint Committee on Cancer (AJCC) cancer stagingcriteria (6th edition), cross-sectional imaging for base of tongue carcinoma is recommended when the deeptissue extent of a primary tumor is in question. The aim of this study was to establish which group of patientsMRI might most benefit from accurate clinical staging of base of tongue carcinomas. Patients and
Methods:The clinical stagings of 33 patients with pathologically proven squamous cell carcinomas of the base of tonguewere performed by two otorhinolaryngologic surgeons. Their results were compared with the results from MRIinterpreted by a neuroradiologist and the numbers of patients being upstaged, downstaged or with an unchangedstage were recorded and analyzed.
Results: The tumor stages were changed in 13 of 33 patients (39.4%, 95%CI: 23.9-57.87%) and the overall stage groupings were changed in 10 (30.3 %, 95%CI: 15.6-48.7%) afterperforming MRI. Mis-staging by clinical examination in the overall stage grouping was as high as 83.3% (95%CI:35.9-99.6%) in stages II and III and 85.7% (95% CI: 42.1-99.6%) in T3.
Conclusion: MRI should be recommendedin base of tongue carcinoma whenever clinical examination suggests overall stage groupings II, III or tumorstage T3.