Skip to main content
SpringerLink
Log in

Diagnostic performance of MRI for the assessment of extraocular muscle invasion in malignant sinonasal tumors

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Preoperative assessment of extraocular muscle invasion is essential for therapeutic strategies and prognostic evaluation. The aim of this study was to assess the diagnostic accuracy of MRI for evaluation of extraocular muscle (EM) invasion by malignant sinonasal tumors.

Materials and methods

Consecutively, 76 patients of sinonasal malignant tumors with orbital invasion were included in the present study. Preoperative MRI imaging features were analyzed by two radiologists independently. The diagnostic performances of MR imaging features for detecting EM involvement were evaluated by comparing imaging findings to histopathology data.

Results

A total of 31 extraocular muscles were involved by sinonasal malignant tumors in 22 patients, including 10 medial rectus muscles (32.2%), 10 inferior rectus muscles (32.2%), 9 superior oblique muscles (29.1%), and 2 external rectus muscles (6.5%). The EM involved by sinonasal malignant tumors usually showed relatively high signal intensity on T2-weighted images, indistinguishable from the tumor, nodular enlargement and abnormal enhancement (p = 0.001, < 0.001, < 0.001 and < 0.001, respectively). Using a combination of EM abnormal enhancement and indistinguishable from the tumor in multivariate logistic regression analysis, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for detecting orbital EM invasion by sinonasal tumors were 93.5, 85.2, 76.3, 96.3 and 88%, respectively.

Conclusion

MRI imaging features show high diagnostic performance for the diagnosis of extraocular muscle invasion by malignant sinonasal tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Availability of data and materials

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Castelnuovo P, Lambertoni A, Sileo G et al (2021) Critical review of multidisciplinary approaches for managing sinonasal tumors with orbital involvement. Acta Otorhinolaryngol Ital 41(1):S76–S89. https://doi.org/10.14639/0392-100X-suppl.1-41-2021-08

    Article  PubMed  PubMed Central  Google Scholar 

  2. Neel GS, Nagel TH, Hoxworth JM, Lal D (2017) Management of orbital involvement in sinonasal and ventral skull base malignancies. Otolaryngol Clin North Am 50(2):347–364. https://doi.org/10.1016/j.otc.2016.12.010

    Article  PubMed  Google Scholar 

  3. Carrillo JF, Güemes A, Ramírez-Ortega MC, Oñate-Ocaña LF (2005) Prognostic factors in maxillary sinus and nasal cavity carcinoma. Eur J Surg Oncol 31(10):1206–1212. https://doi.org/10.1016/j.ejso.2005.04.001

    Article  CAS  PubMed  Google Scholar 

  4. Ganly I, Patel SG, Singh B et al (2005) Craniofacial resection for malignant paranasal sinus tumors: report of an International Collaborative Study. Head Neck 27(7):575–584. https://doi.org/10.1002/hed.20165

    Article  PubMed  Google Scholar 

  5. Amin MB, Greene FL, Edge SB, et al (2017) The Eighth Edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin 67(2):93–99. https://doi.org/10.3322/caac.21388

  6. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (eds) (2010) AJCC cancer staging manual, 7th edn. Springer, New York

  7. Lisan Q, Kolb F, Temam S, Tao Y, Janot F, Moya-Plana A (2016) Management of orbital invasion in sinonasal malignancies. Head Neck 38(11):1650–1656. https://doi.org/10.1002/hed.24490

    Article  PubMed  Google Scholar 

  8. Muscatello L, Fortunato S, Seccia V, Marchetti M, Lenzi R (2016) The implications of orbital invasion in sinonasal tract malignancies. Orbit 35(5):278–284. https://doi.org/10.1080/01676830.2016.1193532

    Article  PubMed  Google Scholar 

  9. Mody MD, Saba NF (2020) Multimodal therapy for sinonasal malignancies: updates and review of current treatment. Curr Treat Options Oncol 21(1):4. https://doi.org/10.1007/s11864-019-0696-4

    Article  PubMed  Google Scholar 

  10. Vartanian JG, Toledo RN, Bueno T, Kowalski LP (2018) Orbital exenteration for sinonasal malignancies: indications, rehabilitation and oncologic outcomes. Curr Opin Otolaryngol Head Neck Surg 26(2):122–126. https://doi.org/10.1097/MOO.0000000000000441

    Article  PubMed  Google Scholar 

  11. Salfrant M, Garcia GCTE, Guichard JP et al (2021) Imaging of skull base and orbital invasion in sinonasal cancer: correlation with histopathology. Cancers (Basel) 13(19):4963. https://doi.org/10.3390/cancers13194963

    Article  PubMed  Google Scholar 

  12. Meerwein CM, Pazahr S, Soyka MB, Hüllner MW, Holzmann D (2020) Diagnostic accuracy of computed tomography and magnetic resonance imaging compared to surgical exploration for anterior skull base and medial orbital wall infiltration in advanced sinonasal tumors. Head Neck 42(8):2002–2012. https://doi.org/10.1002/hed.26129

    Article  PubMed  Google Scholar 

  13. Kim HJ, Lee TH, Lee HS, Cho KS, Roh HJ (2006) Periorbita: computed tomography and magnetic resonance imaging findings. Am J Rhinol 20(4):371–374. https://doi.org/10.2500/ajr.2006.20.2889

    Article  PubMed  Google Scholar 

  14. Eisen MD, Yousem DM, Loevner LA, Thaler ER, Bilker WB, Goldberg AN (2000) Preoperative imaging to predict orbital invasion by tumor. Head Neck 22(5):456–462. https://doi.org/10.1002/1097-0347(200008)22:5%3c456::aid-hed3%3e3.0.co;2-n

    Article  CAS  PubMed  Google Scholar 

  15. Patrinely JR, Osborn AG, Anderson RL, Whiting AS (1989) Computed tomographic features of nonthyroid extraocular muscle enlargement. Ophthalmology 96(7):1038–1047. https://doi.org/10.1016/s0161-6420(89)32785-0

    Article  CAS  PubMed  Google Scholar 

  16. Rana K, Juniat V, Patel S, Selva D (2022) Extraocular muscle enlargement. Graefes Arch Clin Exp Ophthalmol 260(11):3419–3435. https://doi.org/10.1007/s00417-022-05727-1

    Article  PubMed  PubMed Central  Google Scholar 

  17. Eade EL, Hardy TG, McKelvie PA, McNab AA (2018) Review of extraocular muscle biopsies and utility of biopsy in extraocular muscle enlargement. Br J Ophthalmol 102(11):1586–1590. https://doi.org/10.1136/bjophthalmol-2017-311147

    Article  PubMed  Google Scholar 

  18. Famuyide A, Juliano A, Moonis G (2021) MRI of sinonasal malignancies. Top Magn Reson Imaging 30(3):139–149. https://doi.org/10.1097/RMR.0000000000000288

    Article  PubMed  Google Scholar 

  19. Choi HY, Yoon DY, Kim ES et al (2019) Diagnostic performance of CT, MRI, and their combined use for the assessment of the direct cranial or intracranial extension of malignant head and neck tumors. Acta Radiol 60(3):301–307. https://doi.org/10.1177/0284185118778883

    Article  PubMed  Google Scholar 

  20. Ferrari M, Migliorati S, Tomasoni M et al (2021) Sinonasal cancer encroaching the orbit: ablation or preservation? Oral Oncol. 114:105185. https://doi.org/10.1016/j.oraloncology.2021.105185

    Article  PubMed  Google Scholar 

  21. Greaves GH, Livingston K, Liu GT et al (2017) Orbital ultrasonography in the diagnosis of neoplastic extraocular muscle enlargement. Orbit 36(5):317–321. https://doi.org/10.1080/01676830.2017.1337173

    Article  PubMed  Google Scholar 

Download references

Funding

Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20190203); Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201704); National Key Technology Research and Development Program of the Ministry of Science and Technology of China (2015BAll6H00); High Level Health Technical Personnel of Bureau of Health in Beijing (2014-2-005).

Author information

Author notes

    Authors and Affiliations

    1. Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China

      Zhenchao Sun, Xinyan Wang, Qian Wang & Junfang Xian

    2. Department of Radiology, Linyi People’s Hospital, Linyi, China

      Zhenchao Sun

    Authors
    1. Zhenchao Sun
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Xinyan Wang
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Qian Wang
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Junfang Xian
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Junfang Xian.

    Ethics declarations

    Conflict of interest

    The authors declare that they have no conflict of interest.

    Additional information

    Publisher's Note

    Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

    Zhenchao Sun and Xinyan Wang contributed equally to this study

    Rights and permissions

    Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Sun, Z., Wang, X., Wang, Q. et al. Diagnostic performance of MRI for the assessment of extraocular muscle invasion in malignant sinonasal tumors. Eur Arch Otorhinolaryngol 280, 3687–3693 (2023). https://doi.org/10.1007/s00405-023-07874-5

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00405-023-07874-5

    Keywords

    Search

    Navigation