Diagnostic Accuracy of Multidetector Computed Tomography (MDCT) for Mandibular Bone Invasion in Oral Squamous Cell Carcinoma (OSCC): A Histopathologic Validation Study.

Authors

Kyoung-Chan Park, Jong-Won Kim, Hyo-Joon Kim, Ji-Su Oh, Seong-Yong Moon

Published in

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. Aug 05, 2026. Epub Aug 05, 2026.

Abstract

Mandibular bone invasion is a critical determinant of staging and surgical planning in oral squamous cell carcinoma (OSCC). Although multidetector computed tomography (MDCT) is widely used, its diagnostic performance in gingival OSCC requires multi-institutional validation.
To evaluate the diagnostic accuracy of preoperative MDCT in detecting mandibular bone invasion in gingival OSCC patients, using histopathologic findings as the reference standard.
A multicenter retrospective cohort study included patients with gingival OSCC who underwent surgical resection at 7 university hospitals between 2020 and 2024; those with prior head and neck radiotherapy or chemotherapy, previous mandibular surgery, or extensive dental artifacts on MDCT were excluded.
The predictor variable was the radiologic diagnosis of mandibular bone invasion (present/absent), determined via consensus review of preoperative MDCT images by 2 oral and maxillofacial radiologists.
The primary outcome variable was histopathologic confirmation of mandibular bone invasion (present/absent) through microscopic examination of decalcified surgical specimens.
Covariates included demographics (age, sex [male/female at birth]), surgery type (marginal or segmental resection), and MDCT bone invasion patterns (cortical destruction, medullary invasion, inferior alveolar canal involvement).
Diagnostic performance parameters with 95% CIs were calculated, and multivariable logistic regression analysis was performed to identify independent predictors of mandibular invasion; statistical significance was defined as a two-sided P value < .05.
A total of 145 patients were screened, and 121 (83.4%) subjects met the inclusion criteria for the final analysis. The sample was composed of 121 subjects with a mean age of 64.2 (SD, 12.8) years, and 74 (61.2%) were male at birth. MDCT showed a sensitivity of 83.5% and a specificity of 61.9% for detecting mandibular bone invasion. The overall diagnostic accuracy was 76.0%. Statistical analysis revealed that cortical destruction and medullary invasion on MDCT were statistically significantly associated with histopathologic bone involvement (P < .001).
MDCT is an accurate imaging modality for detecting mandibular bone invasion in gingival OSCC, exhibiting high sensitivity (83.5%) but lower specificity (61.9%) due to inflammatory mimics. These findings suggest that while MDCT is excellent for preoperative screening and surgical planning, positive radiologic findings should be interpreted with caution to avoid potential over-treatment.

PMID:
42604725
Bibliographic data and abstract were imported from PubMed on 17 Aug 2026.

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