Diagnostic performance of depth of invasion, thickness, and styloglossus and hyoglossus muscle invasion on magnetic resonance imaging in predicting potential neck lymph node metastasis in clinical N0 tongue cancer

To evaluate previously reported quantitative (tumor thickness 11 mm and depth of invasion [DOI] 7.5 mm) and qualitative (styloglossus/hyoglossus muscle invasion [SHMI]) magnetic resonance imaging (MRI) parameters for predicting occult neck node metastasis in clinical N0 oral tongue squamous cell carcinoma.

This single-center retrospective study included 76 patients. MRI images were independently reviewed by two radiologists for tumor thickness, DOI, and SHMI. Statistical analysis assessed the predictive capability of these parameters for 2-year potential lymph node metastasis.

Among the 76 cases, 30.2% developed 2-year potential lymph node metastasis. For tumor thickness ≥ 11 mm, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 0.46, 0.68, 0.37, 0.75, and 0.61, respectively. DOI ≥ 7.5 mm exhibited a sensitivity, specificity, PPV, NPV, and accuracy of 0.73, 0.59, 0.42, 0.84, and 0.63, respectively. SHMI demonstrated a sensitivity, specificity, PPV, NPV, and accuracy of 0.87, 0.51, 0.46, 0.89, and 0.63, respectively.

DOI ≥ 7.5 mm and SHMI demonstrated comparable diagnostic accuracy in predicting neck metastasis, surpassing tumor thickness of > 11 mm. These findings underscore their potential utility in guiding decisions concerning elective neck dissection.