Article Figures & Data
Figures
- FIG 1.
Representative 5-point scale preoperative MR imaging scores for tumor spread through the pharyngeal constrictor muscle. A, Axial T2WI of a 79-year-old man with left-tonsillar SCC revealing a normal constrictor muscle (arrow) (score 1). B, Axial T2WI of a 59-year-old man with right-tonsillar SCC revealing the bulging contour of the constrictor muscle due to the tumor, but normal thickness (arrow) (score 2). C, Axial T2WI of a 66-year-old man with left-tonsillar SCC reveals thinning of the constrictor muscle due to the tumor (score 3). Note that the thickness of the left constrictor muscle is reduced compared with the right side (arrows). D, Axial T2WI of a 69-year-old man with left tonsillar SCC revealing the obscured margin of the constrictor muscle by the tumor (score 4). Note that the normal contour of the constrictor muscle is not visualized (arrows). E, Axial T2WI of a 54-year-old man with right-tonsillar SCC revealing definite protrusion of the tumor into the parapharyngeal fat (arrows) (score 5).
- FIG 2.
ROC curves for diagnosing an insecure surgical margin according to MR imaging scores for the pharyngeal constrictor muscle involvement. The ROC curve of the MR imaging score of ≥4 (red) has the highest AUC value of 0.899, followed by the MR imaging score of ≥3 (green, AUC value of 0.846), MR imaging score of ≥2 (blue, AUC value of 0.692), and MR imaging score of 5 (orange, AUC value of 0.500).
Tables
Insecure Margin (n = 16) Negative Margin (n = 13) P Value Age (median, range) (yr) 63, 45–80 60, 38–78 .345 Sex (female:male) 0:16 3:10 .078 cT category (No., %) .164 cT1 1, 6.3% 4, 30.8% cT2 14, 87.5% 9, 69.2% cT3 0, 0% 0, 0% cT4 1, 6.3% 0, 0% cN category (No., %) .422 cN0 1, 6.3% 2, 15.4% cN1 15, 93.8% 11, 84.6% pT category (No., %) .202 pT1 2, 12.5% 5, 38.5% pT2 13, 81.3% 8, 61.5% pT3 0, 0% 0, 0% pT4 1, 6.3% 0, 0% pN category (No., %) .625 pNx 1, 6.3% 1, 7.7% pN0 1, 6.3% 1, 6.3% pN1 12, 75.0% 10, 76.9% pN2 2, 12.5% 1, 7.7% Histopathologic differentiation (No., %) .310 Well 2, 12.5% 0, 0% Moderate 5, 31.3% 8, 61.5% Poor 4, 25.0% 2, 15.4% Not applicablea 5, 31.3% 3, 23.1% Positive LVI (No., %) 8, 50.0% 5, 38.5% .705 Positive perineural invasion (No., %) 2, 12.5% 0, 0% .359 Treatment technique (No., %) .485 TORS alone 5, 31.3% 6, 46.2% TORS+adjuvant radiation 4, 25.0% 4, 30.8% TORS+adjuvant chemoradiation 7, 43.8% 3, 23.1% Note—LVI indicates lymphovascular invasion.
↵a No pathologic statement of the histopathologic differentiation.
- Table 2:
Diagnostic performance of the MR imaging score for predicting an insecure surgical margin
Cutoff Value AUC (95% CI) Sensitivity (%) (95% CI) Specificity (%) (95% CI) ≥2 0.692 (0.494–0.849) 100.0 (79.4–100.0) 38.5 (13.9–68.4) ≥3 0.846 (0.664–0.952) 100.0 (79.4–100.0) 69.2 (38.6–90.9) ≥4 0.899 (0.730–0.979) 87.5 (61.7–98.4) 92.3 (64.0–99.8) 5 0.500 (0.310–0.690) 0.0 (0.0–24.7) 100.0 (79.4–100.0) Factors Contrast OR 95% CI P Value cT category cT1 vs cT2 4.58 0.701–51.21 .115 cT1 vs cT4 9.0 0.303–1669.30 .208 cN category cN0 vs cN1 2.25 0.262–27.08 .56 pT category pT1 vs pT2 3.49 0.666–23.32 .141 pT1 vs pT4 6.6 0.255–1118.92 .259 pN category pN0 vs pNx 1.0 0.034–29.19 1.0 pN0 vs pN1 1.09 0.079–14.88 .946 pN0 vs pN2 5.0 0.148–965.12 .378 Histopathologic differentiation Well vs moderate 0.13 0.001–2.00 .153 Well vs poor 0.36 0.002–7.44 .533 LVI Positive vs negative 1.31 0.296–6.094 .724 Perineural invasion Positive vs negative 2.61 0.128–394.57 .543 Treatment technique TORS only vs TORS+adjuvant radiation 0.78 0.124–4.61 .78 TORS only vs TORS+adjuvant chemoradiation 2.14 0.415–12.46 .366 MR imaging score 1 vs 2–5 21.35 2.03–2930.98 .007a 1–2 vs 3–5 69.67 6.68–9652.57 <.0001a 1–3 vs 4–5 48.33 7.131–634.53 <.0001a 1–4 vs 5 3.99 0.653–43.33 .14 ↵a P values < .05.
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