The Use of Intraoperative PET-CT in the Assessment of Surgical Margins for Patients With Oral Squamous Cell Carcinoma.

BACKGROUND: The importance of ensuring clear margins following resection for oral squamous cell carcinoma (OSCC) has been well described in the literature, however, accurate intra-operative assessment of tumor margins in these patients remains problematical. Positive margins are known to be associated with a significant reduction in survival and the addition of adjuvant radiotherapy for this group of patients does not change survival, meaning that patients are subjected to the additional co-morbidities of chemo-radiation. METHOD: We describe the use of a novel intra-operative PET-CT scanner (Aura 10, Xeos, Ghent) to evaluate margin status for 18 patients undergoing excision of OSCC. RESULTS: Intra-operative PET-CT showed a high positive predictive value for positive margins but was less accurate in confirming a negative margin. CONCLUSION: This new technology shows early promise in improving margin resection rates in oral cancer patients but requires a larger sample size or multi-center trial for further evaluation.