Detecting and defining the anatomical extent of perineural spread of malignancy: Comparing “targeted” MRI imaging with the histological findings following surgery

Gandhi, M. R., Panizza, B. and Kennedy, D. (2011) Detecting and defining the anatomical extent of perineural spread of malignancy: Comparing “targeted” MRI imaging with the histological findings following surgery. Head and Neck, 33 4: 469-475. doi:10.1002/hed.21470


Author Gandhi, M. R.
Panizza, B.
Kennedy, D.
Title Detecting and defining the anatomical extent of perineural spread of malignancy: Comparing “targeted” MRI imaging with the histological findings following surgery
Journal name Head and Neck   Check publisher's open access policy
ISSN 1043-3074
1097-0347
Publication date 2011-04
Year available 2010
Sub-type Article (original research)
DOI 10.1002/hed.21470
Volume 33
Issue 4
Start page 469
End page 475
Total pages 7
Place of publication Hoboken, NJ, United States
Publisher John Wiley and Sons
Collection year 2012
Language eng
Formatted abstract
Background. The accurate preoperative identification
of the extent of perineural spread (PNS) of malignancy
along a cranial nerve is vital to the design of an appropriate
surgical resection. Our purpose was to determine the sensitivity
of targeted MRI in predicting the presence of disease and
the anatomic extent of spread when compared with histologic
findings.
Methods. A retrospective review was performed of 25
patients with PNS who had targeted MRI and surgery to excise
perineural tumor (2002–2008).
Results. MRI detected PNS in 30 of 30 nerves (100%) with
1 false positive. MRI correctly identified the extent of spread
based on histology in 25 of 30 nerves (83.3%). In 4 of 30
cases (13.3%) MRI underestimated the extent of spread proximal
to the Gasserian ganglion that, if diagnosed preoperatively,
may have deemed the patient inoperable.
Conclusions. MRI demonstrated the presence and anatomic
extent of PNS in the majority of cases. MRI may underestimate
microscopic spread proximal to the Gasserian
ganglion.
Keyword Perineural spread
MRI
Head And Neck
Neoplasms
Nerve
Trigeminal
Nerves
Facial
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 19 JUL 2010

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Sun, 26 Jun 2011, 21:20:28 EST by Dr Benedict Panizza on behalf of Surgery - Princess Alexandra Hospital