Abstract:

Objective To assess the diagnostic efficacy of contrast-enhanced CT in diagnosing mandibular invasion of oral cancers. Methods  PubMed, Excerpta Medica Database (EMBASE), the European Grey Literature Database, Chinese Biomedical Literature Database (CBM), and CQVIP were searched electronically on January 03, 2014. Hand-searching was also performed on 19 relevant Chinese journals. The methodological quality assessment, as suggested in Cochrane Handbook, and the data extraction of the studies included were performed by two reviewers in duplicate. Meta-analysis was conducted using the Meta Disc 1.4 software. Results  Fourteen studies that involved 642 participants were included. Among the seven prospective studies, one had a low bias risk and the rest had unclear bias risks. When mandibular invasion was diagnosed the Meta-analysis results showed that the pooled sensitivity (SEN) was 0.718 [95% confidence interval (CI), 0.665-0.767], the pooled specificity (SPE) was 0.909 (95% CI, 0.872–0.938), the area under curve (AUC) was 0.906 1, and the Q* was 0.837 8. When mandibular medullary invasion was diagnosed, the SEN was 0.787 (0.643–0.893), the SPE was 0.904 (0.790–0.968), the AUC was 0.949 6, and the Q* was 0.890 0. The Meta-regression results showed that the smaller slide thickness had a higher diagnosis efficacy. Conclusion CT showed a high efficacy in diagnosing mandibular or medullary invasion caused by oral cancers. With a high SPE, contrast-enhanced CT can confirm the clinical diagnosis of bone invasion effectively. In addition, selecting a smaller slide thickness CT can increase diagnosis efficacy.

Key words: contrast-enhanced CT, oral cancer, mandible, diagnosis, Meta-analysis, systematic review