The emerging role of dynamic contrast enhanced mri in differentiation between various histologic subtypes of oral cavity squamous cell carcinoma

Differentiating histologic subtypes and assessing tumor grade of oral squamous cell carcinoma using conventional contrast-enhanced MRI can be challenging. Newer advanced imaging MRI technique such as dynamic contrast-enhanced MRI (DCE-MRI) provides assessment of prognosis and malignant potential of tumor by studying tissue microcirculation and blood perfusion. This study aims to determine whether dynamic contrast-enhanced (DCE) perfusion MRI can distinguish between histologic subtypes of oral cavity squamous cell carcinoma (SCC). Sixty-two patients with newly diagnosed tumor lesions underwent both conventional contrast-enhanced MRI and DCE perfusion. The DCE parameters from the tumor lesions were compared with normal tissue. A Student's t-test was used to assess statistical significance, with p-values < 0.05 considered significant. The malignancy group was further divided into low-grade and high-grade subtypes for comparison. High-grade cancers (stage I/II) significantly increased quantitative perfusion parameters (Ktrans, Ve, and Kep) compared to low-grade (Stage III/IV) subtypes which is statistically significant (p <0.001). There was no significant difference in the quantitative parameters between well-differentiated and moderately differentiated subtypes. High-grade tumors predominantly exhibited a Type III signal intensity curve. DCE MRI perfusion parameters and signal intensity curves can effectively differentiate low-grade from high-grade oral cavity SCC thereby addressing the specific diagnostic gap in field of oral malignancy.