Comparison of Intraoperative Sonography and Histopathologic Evaluation of Tumor Thickness and Depth of Invasion in Oral Tongue Cancer: A Pilot Study

Yoon, Byung Chul; Bulbul, Mustafa G.; Sadow, Peter M.; Faquin, William C.; Curtin, Hugh D.; Varvares, Mark A.; Juliano, Amy F.

doi:10.3174/ajnr.a6625

Cited by 27 publications

(38 citation statements)

References 11 publications

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“…In another study by Yoon et al. ( 27 ) consisting of 22 patients, the mean sonographic DOI and histologic DOI were 6.6 ± 3.4 and 6.4 ± 4.4 mm, respectively, and there was excellent correlation between sonographic and histologic measurement for DOI, with a Pearson correlation coefficient of 0.95 (95%CI: 0.87–0.98). Filauro et al.…”

Section: Discussionmentioning

confidence: 85%

Neck Management in cT1N0 Tongue Squamous Cell Carcinoma as Determined by Sonographic Depth of Invasion

et al. 2022

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ObjectivesTo compare the oncologic outcomes in patients with cT1N0 tongue squamous cell carcinoma (SCC) who underwent different neck management strategies stratified by sonographic depth of invasion (DOI).MethodsThe included patients were retrospectively enrolled, and divided into two groups: observation (OBS) and elective neck dissection (END). The regional control (RC) and disease-specific survival (DSS) rates were compared and stratified by sonographic DOI.ResultsThe mean sonographic and pathologic DOIs were 3.8 and 3.7 mm, respectively; the two DOIs were significantly correlated (Spearman correlation coefficient 0.974. p <0.001). In patients with sonographic DOI <4.0 mm, the 5-year RC rates were 73 and 89% in the OBS and END groups, respectively, and were not significantly different. However, in patients with sonographic DOI ≥4.0 mm, the 5-year RC rate was significantly different between the OBS (57%) and END (80%) groups (p = 0.031). In patients with sonographic DOI <4.0 mm, the 5-year DSS rates were 79 and 89% in OBS and END groups, respectively, and were not significantly different. However, in patients with sonographic DOI ≥4.0 mm, the 5-year DSS rate was significantly different between the OBS (67%) and END (86%) groups (p = 0.033).ConclusionsSonographic DOI was notably correlated with pathologic DOI. Moreover, there was a significant survival difference between the OBS and END groups in cT1N0 tongue SCC patients with sonographic DOI ≥4.0 mm but not in those with sonographic DOI <4.0 mm. Our study provides a useful method to aid decision-making in the clinical setting for this patient group.

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Section: Discussionmentioning

confidence: 85%

Neck Management in cT1N0 Tongue Squamous Cell Carcinoma as Determined by Sonographic Depth of Invasion

et al. 2022

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“…There are many comparative studies between r-DOI and p-DOI using ultrasound 8 , 19 or MRI 3 , 7 , 20 , 21 . Several studies stated that CT 22 , 23 is also useful for evaluation of r-DOI; however, CT cannot evaluate r-DOI when the contrast is low, superficial lesions cannot be detected, and metal artifacts often disturb images of tumor location.…”

Section: Discussionmentioning

confidence: 99%

“…The radiological DOI (r-DOI) is frequently measured by CT, MRI, and ultrasound in tongue SCC. Previous studies have reported significant relationship between r-DOI measured on these modalities and pathological DOI (p-DOI) in the tongue SCC 8 – 12 . r-DOI differs from the tumor thickness (TT), and is defined as the distance from a virtual normal mucous membrane to the tumor’s deepest part on the image.…”

Section: Introductionmentioning

confidence: 97%

MRI before biopsy correlates with depth of invasion corrected for shrinkage rate of the histopathological specimen in tongue carcinoma

Harada

Tomioka

Hirai

et al. 2021

Sci Rep

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The purpose of this study was to evaluate which radiological depth of invasion (r-DOI) measurement is the most concordant to clinical DOI (c-DOI) derived from correction for the shrinkage rate of the histopathological specimens. We retrospectively reviewed 128 patients with tongue carcinoma who had undergone glossectomy between 2006 and 2019. At first, the width shrinkage rate during formalin fixation and preparation process of histopathological specimens was evaluated. From the shrinking rates, a formula to calculate c-DOI from pathological DOI (p-DOI) was developed. The correlation between c-DOI and r-DOI was evaluated. The specimen shrinkage rate during the histopathological specimen preparation process was 10.3%. Based on that, we yielded the correct formula for c-DOI based on p-DOI and preparation shrinkage rate: c-DOI = p-DOI × 100/89.7. The regression equations for the association of c-DOI with r-DOI measured by ultrasound (n = 128), MRI before biopsy (n = 18), and MRI after biopsy (n = 110) were y = 1.12 * x + 0.21, y = 0.89 * x − 0.26, and y = 0.52 * x + 2.63, respectively, while the coefficients of determination were 0.664, 0.891, and 0.422, respectively. In conclusion, r-DOI using MRI before biopsy most strongly correlated with c-DOI.

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“…There are numerous studies suggested that preoperative or intraoperative US is reliable for the assessment of TT or DOI in oral cancer and can potentially guide the surgeon in the achievement of adequate resection margins, especially the deep margin ( Figure 1A and B ). 3 , 4 , 19 – 26 , 38 The correlation between the US-obtained and histology-obtained TT or DOI is good to strong with Spearman R = 0.760-0.988, 3 , 4 , 8 , 19 – 26 , 38 and some studies show that US is better than computed tomography (CT) and magnetic resonance imaging (MRI) at determining the deep margins of oral cancer. 8 , 22 , 26 , 39 , 40 This technique is reported to be particularly reliable in tongue cancers with TT or DOI under 10 mm.…”

Section: Pretreatment and Surgical Phasementioning

confidence: 99%

The Applications and Potential Developments of Ultrasound in Oral Cancer Management

Chang

Cheng

et al. 2022

Technol Cancer Res Treat

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Oral cancer is endemic and causes a great burden in Southern Asia. It is preferably treated by surgery with/without adjuvant radiotherapy (RT) or chemoradiation therapy, depending on the stage of the disease. Close or positive resection margin and cervical lymph node (LN) metastasis are important prognostic factors that have been presented to be related to undesirable locoregional recurrence and poor survival. Ultrasound (US) is a simple, noninvasive, time-saving, and inexpensive diagnostic modality. It can depict soft tissues very clearly without the risk of radiation exposure. Additionally, it is real-time and continuous image is demonstrated during the exam. Furthermore, the clinician can perform US-guided fine needle aspiration (FNA) or core needle biopsy (CNB) at the same time. US with/without US-guided FNA/CNB is reported to be of value in determining tumor thickness (TT), depth of invasion (DOI), and cervical LN metastasis, and in aiding the staging of oral cancer. DOI has a relevant prognostic value as reported in the eighth edition of the American Joint Committee on Cancer staging of oral cancer. In the present review, we describe the clinical applications of US in oral cancer management in different phases and potential applications in the future. In the pretreatment and surgical phase, US can be used to evaluate TT/DOI and surgical margins of oral cancer in vivo and ex vivo. The prediction of a malignant cervical LN (nodal metastasis) by the US-based prediction model can guide the necessity of FNA/CNB and elective neck dissection in clinical early-stage oral cancer. In the posttreatment surveillance phase, US with/without US-guided FNA or CNB is helpful in the detection of nodal persistence or LN recurrence, and can assess the possibility and extent of carotid artery stenosis after irradiation therapy. Both US elastography and US swallowing assessment are potentially helpful to the management of oral cancer.

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Comparison of Intraoperative Sonography and Histopathologic Evaluation of Tumor Thickness and Depth of Invasion in Oral Tongue Cancer: A Pilot Study

Cited by 27 publications

References 11 publications

Neck Management in cT1N0 Tongue Squamous Cell Carcinoma as Determined by Sonographic Depth of Invasion

Neck Management in cT1N0 Tongue Squamous Cell Carcinoma as Determined by Sonographic Depth of Invasion

MRI before biopsy correlates with depth of invasion corrected for shrinkage rate of the histopathological specimen in tongue carcinoma

The Applications and Potential Developments of Ultrasound in Oral Cancer Management

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