Diagnostic Performance of MRI for the Assessment of Extraocular Muscle Invasion in Malignant Sinonasal Tumors

Overview

Journal Eur Arch Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2023 Feb 22

PMID 36811653

Authors

Zhenchao Sun

Xinyan Wang

Qian Wang

Junfang Xian

Affiliations

Soon will be listed here.

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.

Citing Articles

Diagnostic Accuracy of MRI for Orbital and Intracranial Invasion of Sinonasal Malignancies: A Systematic Review and Meta-Analysis.

Abdullaeva U, Pape B, Hirvonen J J Clin Med. 2025; 13(24.

PMID: 39768479 PMC: 11728326. DOI: 10.3390/jcm13247556.

References

Castelnuovo P, Lambertoni A, Sileo G, Valentini M, Karligkiotis A, Battaglia P . Critical review of multidisciplinary approaches for managing sinonasal tumors with orbital involvement. Acta Otorhinolaryngol Ital. 2021; 41(Suppl. 1):S76-S89. PMC: 8172109. DOI: 10.14639/0392-100X-suppl.1-41-2021-08. View

Neel G, Nagel T, Hoxworth J, Lal D . Management of Orbital Involvement in Sinonasal and Ventral Skull Base Malignancies. Otolaryngol Clin North Am. 2017; 50(2):347-364. DOI: 10.1016/j.otc.2016.12.010. View

Carrillo J, Guemes A, Ramirez-Ortega M, Onate-Ocana L . Prognostic factors in maxillary sinus and nasal cavity carcinoma. Eur J Surg Oncol. 2005; 31(10):1206-12. DOI: 10.1016/j.ejso.2005.04.001. View

Ganly I, Patel S, Singh B, Kraus D, Bridger P, Cantu G . Craniofacial resection for malignant paranasal sinus tumors: Report of an International Collaborative Study. Head Neck. 2005; 27(7):575-84. DOI: 10.1002/hed.20165. View

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

Muscatello L, Fortunato S, Seccia V, Marchetti M, Lenzi R . The implications of orbital invasion in sinonasal tract malignancies. Orbit. 2016; 35(5):278-84. DOI: 10.1080/01676830.2016.1193532. View

Mody M, Saba N . Multimodal Therapy for Sinonasal Malignancies: Updates and Review of Current Treatment. Curr Treat Options Oncol. 2020; 21(1):4. DOI: 10.1007/s11864-019-0696-4. View

Vartanian J, Toledo R, Bueno T, Kowalski L . Orbital exenteration for sinonasal malignancies: indications, rehabilitation and oncologic outcomes. Curr Opin Otolaryngol Head Neck Surg. 2018; 26(2):122-126. DOI: 10.1097/MOO.0000000000000441. View

Salfrant M, Garcia G, Guichard J, Bidault F, Reizine D, Auperin A . Imaging of Skull Base and Orbital Invasion in Sinonasal Cancer: Correlation with Histopathology. Cancers (Basel). 2021; 13(19). PMC: 8507735. DOI: 10.3390/cancers13194963. View

10.

Meerwein C, Pazahr S, Soyka M, Hullner M, Holzmann D . 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. 2020; 42(8):2002-2012. DOI: 10.1002/hed.26129. View

11.

Kim H, Lee T, Lee H, Cho K, Roh H . Periorbita: computed tomography and magnetic resonance imaging findings. Am J Rhinol. 2006; 20(4):371-4. DOI: 10.2500/ajr.2006.20.2889. View

12.

Eisen M, Yousem D, Loevner L, Thaler E, Bilker W, Goldberg A . Preoperative imaging to predict orbital invasion by tumor. Head Neck. 2000; 22(5):456-62. DOI: 10.1002/1097-0347(200008)22:5<456::aid-hed3>3.0.co;2-n. View

13.

Patrinely J, Osborn A, Anderson R, Whiting A . Computed tomographic features of nonthyroid extraocular muscle enlargement. Ophthalmology. 1989; 96(7):1038-47. DOI: 10.1016/s0161-6420(89)32785-0. View

14.

Rana K, Juniat V, Patel S, Selva D . Extraocular muscle enlargement. Graefes Arch Clin Exp Ophthalmol. 2022; 260(11):3419-3435. PMC: 9581877. DOI: 10.1007/s00417-022-05727-1. View

15.

Eade E, Hardy T, McKelvie P, McNab A . Review of extraocular muscle biopsies and utility of biopsy in extraocular muscle enlargement. Br J Ophthalmol. 2018; 102(11):1586-1590. DOI: 10.1136/bjophthalmol-2017-311147. View

16.

Famuyide A, Juliano A, Moonis G . MRI of Sinonasal Malignancies. Top Magn Reson Imaging. 2021; 30(3):139-149. DOI: 10.1097/RMR.0000000000000288. View

17.

Choi H, Yoon D, Kim E, Baek S, Lim K, Seo Y . 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. 2018; 60(3):301-307. DOI: 10.1177/0284185118778883. View

18.

Ferrari M, Migliorati S, Tomasoni M, Crisafulli V, Nocivelli G, Paderno A . Sinonasal cancer encroaching the orbit: Ablation or preservation?. Oral Oncol. 2021; 114:105185. DOI: 10.1016/j.oraloncology.2021.105185. View

19.

Greaves G, Livingston K, Liu G, Shindler K, Volpe N, Pistilli M . Orbital ultrasonography in the diagnosis of neoplastic extraocular muscle enlargement. Orbit. 2017; 36(5):317-321. DOI: 10.1080/01676830.2017.1337173. View