Is bone scanning still of value?
Reviewed by Stuart Clark

This is an article from Australia of 109 patients, 83 of which had CT, 72 MRI and the presence of bone invasion on imaging was compared with the histopathology. Bone invasion was present in 44 of 109 resection specimens. Bone invasion was identified on CT and 31 of the 83 cases and in 35 of the 72 MRI cases. In conclusion, they indicate that MRI is more sensitive than CT imaging for the detection of bone invasion, both modalities having similar specificity. In early disease where bone invasion is not suspected on clinical grounds, both types of imaging were thought to be highly accurate at ruling out invasion, suggesting a marginal mandibulectomy is more appropriate for these patients. However, in advanced disease, neither imaging type could confidently exclude bone invasion, with approximately 20% of histologically detected invasion not being apparent on CT or MRI. They raised the query about whether a more aggressive resection is merited when bone invasion is detected preoperatively.

Can radiological examination of mandibular bone invasion accurately predict the need for mandibular resection in oral squamous cell carcinoma?
DeAngelis A, Breik O, Angel C, et al.
INTERNATIONAL JOURNAL OF ORAL & MAXILLOFACIAL SURGERY
2019;48:576-83.