Efficacy of CBCT and Conventional Radiography in Identifying Bone Invasion in Oral Cancer - A Comparative Systematic...

Area of Science:

• Oral and Maxillofacial Radiology
• Diagnostic Imaging
• Oncology

Background:

• Bone invasion is a critical factor in staging and surgical planning for oral squamous cell carcinoma (OSCC).
• Accurate pre-operative imaging is essential for detecting cortical and medullary bone involvement in OSCC.

Purpose of the Study:

• To compare the diagnostic efficacy of cone-beam computed tomography (CBCT) against conventional radiography for detecting bone invasion in OSCC.
• To evaluate the performance of CBCT and conventional radiography in identifying osseous involvement in oral cancer.

Main Methods:

• A systematic review and meta-analysis of comparative and observational studies.
• Searched multiple databases including PubMed, Embase, Scopus, Web of Science, and Cochrane Library.
• Assessed diagnostic accuracy using histopathology or intraoperative findings as the gold standard.

Main Results:

• Nineteen studies were included, with CBCT demonstrating higher sensitivity (84.8%-100%) and specificity (60%-100%) compared to conventional radiography (sensitivity 24%-74.1%; specificity 68%-75%).
• CBCT facilitated earlier detection of cortical and trabecular changes, performing comparably to CT for osseous invasion.
• Magnetic resonance imaging (MRI) remains superior for soft-tissue and marrow evaluation.

Conclusions:

• CBCT significantly outperforms conventional radiography in detecting bone invasion associated with OSCC.
• CBCT should be considered in pre-operative evaluations for OSCC, with MRI used for suspected soft-tissue involvement.
• Future research should focus on standardized CBCT protocols and artificial intelligence for improved diagnostic accuracy.