Comparison of Accuracy of Contrast Enhanced Computed Tomography with Accuracy of Non-Contrast Magnetic Resonance Imaging in Evaluation of Local Extension of Base of Tongue Malignancies
Author(s): Ketan Rathod, Akshay Pendkar, Nandini Bahri
Abstract
Diagnosis of base of tongue malignancy can be obtained through clinical examination and biopsy. Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) are used to detect its local extension, nodal spread and distant metastases. The main aim of study was to compare the accuracy of MRI and contrast enhanced CT in determining the local extent of base of tongue malignancy. Twenty five patients, biopsy proven cases of squamous cell carcinoma of base of tongue were taken. 1.5 Tesla Magnetic Resonance Unit with T2 weighted axial, coronal image; T1 weighted axial, coronal image; and STIR (Short tau inversion recovery) axial and coronal images were used. 16 slice Computed Tomography unit with non-contrast and contrast enhanced images were used. Accuracy of CT to detect midline crossing: 50%; accuracy of MRI to detect midline crossing: 100%; accuracy of CT to detect anterior extension: 92%; accuracy of MRI to detect anterior extension: 100%; accuracy of CT to detect tonsillar fossa invasion: 83%; accuracy of MRI to detect tonsillar fossa invasion: 100%; accuracy of CT to detect oro pharyngeal spread: 83%; accuracy of MRI to detect oro pharyngeal spread: 100%; accuracy of CT to detect bone involvement: 20%; accuracy of MRI to detect bone involvement: 100%. MRI proved to be a better investigation than CT, in terms of evaluation of depth of invasion, presence of bony involvement, extension to opposite side, anterior half of tongue, tonsillar fossa, floor of mouth or oropharynx.
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