Accuracy of Magnetic Resonance Imaging in Evaluating the Depth and Level of Invasion of Buccal Carcinoma: A Prospective Cohort Study

This study evaluated the accuracy of magnetic resonance imaging (MRI) in determining the depth and level of invasion of buccal carcinoma. Patients with buccal squamous cell carcinoma diagnosed pathologically from July 2016 to December 2019 were included. The depth of invasion (DOI) and level of invasion (LOI) were evaluated by MRI, intraoperative specimens and pathological sections. Statistical analyses were performed using IBM SPSS software version 25.0 (IBM Corp., Armonk, NY). Forty-nine patients were ultimately included. The overall difference in DOI between MRI and pathological sections (DMP) was 5.55 ± 2.40 mm, and T category correlated with the differences in DOI measurement and LOI assessment. The threshold value of DOI by MRI to identify lymph node metastasis was 8.5 mm, and that for overall survival (OS) and disease-specific survival (DSS) was 14.1 mm for both. Buccinator invasion on MRI correlated with OS and DSS. Tumors with MRI-derived DOI larger than 8.5 mm deserve simultaneous neck dissection at initial surgery. Buccinator invasion was found to be an independent prognostic factor for buccal carcinoma patients.