{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:36:18Z","timestamp":1784892978791,"version":"3.55.0"},"reference-count":39,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: To assess the relationship between primary tumor volume, the spatial distribution of cervical lymph node metastases, and TNM (Tumor, node, metastasis) staging in patients with oral squamous cell carcinoma (OSCC) based on high-resolution MRI. Methods: This retrospective analysis evaluated 116 predominantly male (62.9%) patients (age 67.7 \u00b1 11.5 years) with histologically confirmed OSCC who underwent surgical resection with neck dissection or definitive chemoradiation. MRI-based volumetry and center-to-center distance measurements between primary tumor and cervical lymph node metastases were performed using 3D postprocessing software. Results: Tumor-to-lymph node center-to-center distances ranged from 11.7 to 117.3 mm (median: 44.8 mm; interquartile range [IQR]: 32.1\u201359.6 mm). Primary tumor volume ranged from 0.5 to 87.2 cm3 (median: 13.3 cm3; IQR: 6.4\u201321.5 cm3) and was higher in male patients. A significant association was observed between tumor volume and both lymph node distance and pT-stage (p &lt; 0.0001). The association between tumor volume and tumor\u2013node distance was stronger (Spearman\u2019s r = 0.4541, p &lt; 0.0001) than that between pT-stage (TNM classification) and nodal distance (Spearman\u2019s r coefficient =0.2682, p = 0.0036). Conclusion: MRI-based assessment indicated that tumor volume has a stronger association with the spatial extent of lymph node metastases compared with T-stage alone. Larger tumors were associated with greater distances to metastatic lymph nodes. These findings highlight the value of quantitative 3D MRI-based volume and distance analyses in potentially improving surgical and radiotherapeutic planning.<\/jats:p>","DOI":"10.3390\/cancers18040692","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T08:50:03Z","timestamp":1771577403000},"page":"692","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Beyond the T: Volumetric MRI Predicts Lymphatic Spread in Oral Squamous Cell Carcinoma"],"prefix":"10.3390","volume":"18","author":[{"given":"Philipp","family":"Thoenissen","sequence":"first","affiliation":[{"name":"Department of Oral, Cranio-Maxillofacial and Plastic Facial Surgery, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2936-2610","authenticated-orcid":false,"given":"Davide","family":"Giardino","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclearmedicine, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Yel","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclearmedicine, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5218-1075","authenticated-orcid":false,"given":"Thomas J.","family":"Vogl","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclearmedicine, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scherwin","family":"Mahmoudi","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclearmedicine, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea I.","family":"Nica","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclearmedicine, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Diers","sequence":"additional","affiliation":[{"name":"Department of Oral, Cranio-Maxillofacial and Plastic Facial Surgery, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Fleischmann","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Oncology, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Issing","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Sader","sequence":"additional","affiliation":[{"name":"Department of Oral, Cranio-Maxillofacial and Plastic Facial Surgery, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossano","family":"Girometti","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Department of Medicine, University of Udine, University Hospital \u201cS. Maria della Misericordia\u201d, ASUFC, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0004-6378","authenticated-orcid":false,"given":"Tommaso","family":"D\u2019angelo","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Booz","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclearmedicine, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7897-0854","authenticated-orcid":false,"given":"Shahram","family":"Ghanaati","sequence":"additional","affiliation":[{"name":"Department of Oral, Cranio-Maxillofacial and Plastic Facial Surgery, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Renou, A., Guizard, A.-V., Chabrillac, E., Defossez, G., Grosclaude, P., Deneuve, S., Vergez, S., Lapotre-Ledoux, B., Plouvier, S.D., and Dupret-Bories, A. 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