{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:53:58Z","timestamp":1785941638973,"version":"3.56.0"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can Assoc Radiol J"],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This study evaluates the diagnostic value of CT\/MRI-based nodal morphology and three-plane size criteria for identifying pathologically positive (pN+) cervical lymph nodes (LNs) in oral squamous cell carcinoma (OSCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>OSCC patients who underwent neck dissection (2020-2021) were included. Preoperative CT\/MRI were reviewed by an observer blinded to clinicopathological information. Visible LNs were assessed for morphologic abnormality and size in short-axial (SAD), maximum-axial (MAD), and craniocaudal (CC) diameters. Sensitivity and specificity of each imaging parameter were calculated using pathology as the reference standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>CT\/MRI scans from 148 patients were analyzed. Sensitivity\/specificity for detecting pN+ LNs were: 56%\/76% (abnormal morphology-alone), 57%\/72% (morphology\u2009\u00b1\u2009SAD &gt;1.0\u2009cm), 83%\/28% (morphology\u2009\u00b1\u2009MAD &gt;1.0\u2009cm), 86%\/29% (morphology\u2009\u00b1\u2009CC &gt;1.0\u2009cm), and 88%\/24% (morphology\u2009\u00b1\u2009any-plane &gt;1.0\u2009cm). Among 64 morphologically abnormal LNs, 25, 6, and 5 measured \u22641.0\u2009cm in SAD, MAD, and CC, respectively, with pN+ rates of 16\/25 (64%), 4\/6 (66.7%), and 3\/5 (60%). In morphologically \u201cnormal\u201d (homogenous) LNs, sensitivity\/specificity for pN+ detection by &gt;1.0\u2009cm size threshold were: 3%\/95% (SAD), 62%\/36% (MAD), 68%\/39% (CC), and 72%\/32% (any plane).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Abnormal LN morphology is the most reliable CT\/MRI indicator of pN+ disease in OSCC, irrespective of nodal size, although sensitivity remains modest. In morphologically normal LNs, three-plane size assessment, particularly MAD and CC, improves detection of pN+ beyond SAD. These findings support a morphology-first approach to CT\/MRI nodal evaluation and inform an exploratory OSCC-specific decision framework incorporating morphology, multi-plane size assessment, and lymphatic drainage patterns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08465371261465409","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T09:58:06Z","timestamp":1785751086000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Performance of CT\/MRI-Based Lymph Node Morphology With Three-Plane Size Measurements in Oral Cavity Cancer"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5806-7453","authenticated-orcid":false,"given":"Mohd Hafiz","family":"Johari","sequence":"first","affiliation":[{"name":"Division of Head and Neck Imaging, Joint Department of Medical Imaging, The Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"},{"name":"Department of Radiology, Hospital Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7626-4297","authenticated-orcid":false,"given":"Eric","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Imaging, Joint Department of Medical Imaging, The Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"},{"name":"Department of Neuroradiology, Temerty Faculty of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, The Princess Margaret Cancer Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The Princess Margaret Cancer Centre, University of Toronto, ON, Canada"},{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery, The Princess Margaret Cancer Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan","family":"Weinreb","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Princess Margaret Cancer Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Princess Margaret Cancer Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"de Almeida","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery, The Princess Margaret Cancer Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M. 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