05). Figure 1 MRI SE T1 coronal plane (a), SE T1 coronal plane without (b) and after gadolinium (c). MRI

shows a left floor of the mouth tumour that invading the mandible with cortical erosion and medullary bone involvement (arrows). CT in coronal plane (d) Selleckchem Cyclosporin A shows cortical invasion (arrow). Gross speciment (e) and histologycal data (f) confirm the cortical and medullary bone invasion (pathological stage pT4). Figure 2 MRI SE T1 axial planes before (a) and after gadolinium infusion (b); SE T1 coronal planes before (c) and after gadolinium infusion (d). MRI shows alveolar ridge carcinoma (arrows) with an infiltration of the cortical and medullary bone (circles). CT in axial planes (e-f) shows an infiltration of the cortex (arrows). Histologycal data (g-h) shows the only cortical bone infiltration. Figure 3 MRI SE T1 axial (a) and coronal planes before (b) and after gadolinium infusion (c). MRI shows a left floor of the mouth tumour with an infiltration of medullary bone, that demonstrates hypointense signal in T1 and enhancement after gadolinium infusion in the edentulous site (arrows). CT in axial (d-e) planes shows normal mandibular cortex. On check details the histologycal data the mandible was infiltrated (pathological stage T4). On MRI imaging 4 cases were

not confirmed at histological examination and they resulted in four false positives (Figure 4), either because of the supposed marrow infiltration (n = 3) or the supposed cortical erosion (n = 1). In one case MRI analysis didn’t demonstrate a small cortical erosion (3 mm) and this is resulted in a false negative case at MRI. Figure 4 MRI SE T1 coronal planes before Megestrol Acetate (a) and after gadolinium infusion (b); SE T1 axial plane after gadolinium infusion (c). MRI shows a right floor of the mouth tumour with a suspected infiltration of medullary bone in the edentulous site (arrows). CT in coronal (d) sagittal

(e) and axial (f) planes shows a suspected infiltration of the cortex (arrows). The histological result indicated that the mandible was free from neoplastic invasion (pathological stage T3). At MDCT there were 4 false positives because of the supposed cortical infiltration (n = 3) and the supposed cortical erosion with marrow involvement (n = 1) by the readers. Three false negatives were reported at MDCT analysis; in 2 cases the infiltration of the marrow by alveolar ridge without a cortical erosion was not reported at MDCT and in 1 case a small cortical erosion (3 mm) was not seen. Discussion Mandibular involvement represents an important issue for preoperative counselling and operative planning since the resection requires the reconstructive surgery with simply metal plate for small later defects or the use of vascularised bone grafts, in the form of free tissue, in those cases in which segmental mandibular resection is performed.