CT assessment of the correlation between clinical examination, panoramic radiography and bone involvement in oral malignant tumours

Introduction and Objectives: Oral cancer is a dreadful disease occurring most commonly in the Indian subcontinent. Since there is rarely a second chance for cure, initial approach to treatment is important. A crucial factor in pretreatment assessment of these patients is determination of presence and extent of bone invasion. Materials and Methods: A descriptive study was carried out on 25 patients with clinically and histopathologically diagnosed squamous cell carcinoma. Clinical examination, OPG and contrast enhanced CT was carried out on all patients. Bone adjacent to the tumor was assessed on the CT and served as a gold standard. The other two modalities were then compared to the gold standard. Results: The sensitivity and specificity for clinical examination and OPG were 63.2% & 66.7% and 78.9% and 83.3% respectively. The positive predictive value and negative predictive value for clinical examination were 85.7% and 36.4% respectively. The positive predictive value and negative predictive value for OPG were 93.7% and 55.5% respectively. Conclusion: The present study showed that careful clinical examination followed by OPG may serve as a preliminary evaluation to detect probable presence and extent of bone invasion in oral malignancies.