Osseous changes on bone-window MDCT as indicator of perineural spread in palatal adenoid cystic carcinoma.

OBJECTIVES

To evaluate the distribution and prevalence of osseous changes associated with palatal adenoid cystic carcinoma (ACC) perineural spread (PNS) using bone-window MDCT and assess whether these findings correlate with MRI-diagnosed PNS.

MATERIALS AND

METHODS

A retrospective image study was conducted of patients with palatal ACC who underwent pre-treatment MDCT and/or MRI.

RESULTS

Most common osseous changes in bone-window MDCT (N = 38) were erosion and/or enlargement of the canals/fossa/foramina (81.6%). The most frequent affected sites were palatine foramen/canal (76.3%), pterygopalatine fossa (44.7%), foramen rotundum (34.2%) and Vidian canal (31.6%). Mean size of the affected sites was 186.6% relative to the contralateral sites. Additional findings included adjacent palatal bony erosion (76.3%), surrounding bone sclerosis (13.2%), and internal calcification (13.2%). Among patients with both MDCT and MRI (N = 31), the only osseous findings significantly associated with the presence of PNS diagnosed by MRI was bony erosion/enlargement (p = 0.003) with 96.3% sensitivity and 100% specificity.

CONCLUSIONS

Erosion and/or enlargement of foramina, fossae or canals on bone-window MDCT are strongly associated MRI-confirmed PNS.