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Dynamic contrast-enhanced (albumin-Gd-DTPA) magnetic resonance imaging, performed during 2 weeks of daily administration of an inhibitor of tyrosine kinase receptors (SU6668) in an HT-29 colon carcinoma model, revealed the onset of a hyper-enhancing rim, not observed in untreated tumours. To account for tissue heterogeneity in the quantitative analysis, we segmented tumours into three subunits automatically identified by cluster analysis of the enhancement curves using a k-means algorithm. Transendothelial permeability (Kps) and fractional plasma volume (fPV) were calculated in each subunit. An avascular and necrotic region, an intermediate zone and a well-vascularised periphery were reliably identified. During untreated tumour growth, the identified sub-regions did not substantially change their enhancement pattern. Treatment with SU6668 induced major changes at tumour periphery where a significant increase of Kps and fPV was observed with respect to control tumours. Histology revealed a sub-capsular layer composed of hyper-dense viable tumour cells in the periphery of untreated tumours. The rim of viable neoplastic cells was reduced in treated tumours, and replaced by loose connective tissue characterised by numerous vessels, which explains the observed hyper-enhancement. The present data show a peripheral abnormal development of cancer-associated stroma, indicative of an adaptive response to anti-angiogenic treatment. [ABSTRACT FROM AUTHOR]

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Objectives: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Materials and methods: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Results: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Conclusion: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Clinical relevance statement: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Key Points: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor. [ABSTRACT FROM AUTHOR]