Comparative analysis of preoperative CECT scan with histopathology in oral cavity malignancies

Background: Oral cavity carcinomas carries significant morbidity and mortality particularly among the young male population in the developing world due to habitual usage of tobacco and betel quid. The physical examination allows for the visual assessment of the superficial lesions, however, the extent of the deep structure could not be done. The evaluation of the spread of these tumours to the adjacent structures is crucial for the diagnosis, staging and planning for appropriate treatment strategy. Hence cross-sectional imaging like MDCT and MRI plays a vital role in diagnosis, in assessing the spread and staging of these tumours. Objectives: The primary objective of this subject is to determine the comparison of CECT in the detection of the primary T stage and nodal involvement of primary oral cavity tumours with histopathlogical findings. Methods: This study is a restrospective, analytical observational study carried out on 42 patients diagnosed with carcinoma of the oral cavity in our tertiary care hospital for 6 months. MDCT plain and contrast were performed preoperatively for all patients having oral cavity carcinomas to allow for better visualization and characterisation of primary lesions and assess the nodal morphology and invasion of vascular structures. Data from the intraoperative surgical and histopathological findings were collected and compiled and finally correlated with the MDCT findings. Results:   IBM SPSS (Version 26.0) (Released 2020, IBM Corp. New York, US) was used for statistical analysis. Totally fourty-two patients were included in the study of which 61% are females and  39% are males. The commonest age group of presentation was between 50 to 60 years. The t stage of the primary tumor in our study was identified with a 93% accuracy by MDCT. Sensitivity, Specificity, and accuracy of MDCT in identifying osseous erosion were 100%, 80% and 87% respectively. Node involvement by the tumor was identified by MDCT with a sensitivity of 89%, specificity of 97 % and accuracy of  97%. Conclusion: Preoperative assessment by multidetector computed tomography is very crucial for the accurate staging of primary oral cavity tumours which helps the treating physicians in establishing the appropriate treatment strategy in the management of these patients.