Intraoral ultrasonography in the assessment of DOI in oral cavity squamous cell carcinoma: a comparison with magnetic resonance and histopathology

Filauro, Marta; Missale, Francesco; Marchi, Filippo; Iandelli, Andrea; Carobbio, Andrea Luigi Camillo; Mazzola, Francesco; Parrinello, Giampiero; Barabino, Emanuele; Cittadini, Giuseppe; Farina, Davide; Piazza, Cesare; Peretti, Giorgio

doi:10.1007/s00405-020-06421-w

Cited by 29 publications

(41 citation statements)

References 37 publications

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“…Therefore, in this study, the accuracy of diagnostic imaging was estimated by comparing the DOI measured by CT, MRI, and US with the DOI measured histopathologically in the same target group. Few studies have evaluated primary lesions of tongue cancer by CT [ 14 , 15 , 31 ]. Although CT has better spatial resolution than MRI, metal artifacts often make it difficult to evaluate lesions.…”

Section: Discussionmentioning

confidence: 99%

“…This was likely one of the factors that made the 95% limit of agreement in the Bland–Altman analysis larger than that of MRI. Previous reports have suggested that CT is accurate enough to assess the primary lesion of tongue cancer [ 14 , 15 , 31 ], and this effect should also be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

“…Although the UICC and AJCC state that ultrasonography is not suitable for the evaluation of primary lesions [9], some studies have evaluated primary lesions with intraoral ultrasonography (US) and have shown a strong correlation with histopathological thickness or DOI [10][11][12][13]. To date, several reports have been made on CT, MRI, and US preoperative radiological DOI evaluations, but there is no report of a study where these were all performed in a single institution [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Therefore, this study was aimed to investigate the accuracy of preoperative radiological DOI measurement with CT, MRI, and US in the same target group based on histopathologically measured DOI for T1 and T2 tongue cancers, where a diagnosis of DOI around 5 mm is an important diagnostic finding and examine the effectiveness of each imaging modalities with retrospective approach.…”

Section: Introductionmentioning

confidence: 99%

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A comparative study between CT, MRI, and intraoral US for the evaluation of the depth of invasion in early stage (T1/T2) tongue squamous cell carcinoma

et al. 2021

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Objectives This study aimed to clarify the accuracy of intraoral ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) in preoperative image depth of invasion (DOI) measurement of T1/T2 tongue cancer through comparison with histopathological measurements. Methods Imaging of the primary lesions was performed at our hospital; the lesions were classified into T1 and T2 based on the 8th edition of the AJCC/UICC, and surgery performed. There was histopathological confirmation of lesions as squamous cell carcinoma in 48 patients with tongue cancer. T3 and T4 cases, cases in which preoperative chemotherapy and radiation therapy were performed, and cases where biopsy was performed before imaging were excluded. The radiological DOI in US, CT, and MRI and the histopathological DOI as base were comparatively investigated and statistical analyses were performed by Bland–Altman analysis and Spearman's rank correlation coefficient. Results Bland–Altman analysis showed that the US radiological DOI was overestimated by an average of 0.2 mm compared to the histopathological DOI, while CT and MRI radiological DOI were overestimated by an average of 2–3 mm. The comparison of CT and MRI revealed that the difference between the MRI and histopathological DOI, as well as the 95% limit of agreement, were smaller than those of the CT radiological DOI. Conclusions US is the most accurate preoperative diagnostic tool for T1 and T2 squamous cell carcinoma; CT and MRI tend to have an overestimation of about 2–3 mm and so caution is required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A comparative study between CT, MRI, and intraoral US for the evaluation of the depth of invasion in early stage (T1/T2) tongue squamous cell carcinoma

et al. 2021

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“…Filauro et al. ( 28 ) also noted that the mean difference between sonographic DOI and histologic DOI was only 0.3 mm after analyzing the outcome of 49 patients with cT1-3 tongue SCC, and the two DOIs were significantly related. Together with our results, these findings indicate the high reliability and accuracy of DOI evaluation by ultrasound even in cT1 tumors.…”

Section: Discussionmentioning

confidence: 96%

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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“…[19][20][21][22][23] Conventional ultrasonography (US) has been previously employed for the evaluation of maxillofacial diseases, in particular for the preoperative assessment of malignant lesions. [24][25][26][27][28][29] Ultra-high frequency ultrasound (UHFUS) represents an emerging technique for the diagnosis of several pathologic conditions affecting the oral mucosa. UHFUS is characterized by the use of US frequencies in the range between 30 and 100 MHz, providing high-resolution imaging of superficial layers.…”

Section: Introductionmentioning

confidence: 99%

Ultra‐high frequency ultrasound in the differential diagnosis of oral pemphigus and pemphigoid: An explorative study

Izzetti

Nisi

Aringhieri

et al. 2021

Skin Research and Technology

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Objectives: Intraoral ultra-high frequency ultrasound (UHFUS) is an emerging technique in oral medicine, due to its possibility to provide submillimeter resolution imaging of superficial mucosal structures. In this study, the potential role of UHFUS in the diagnosis of oral pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) is assessed. Materials and Methods: Consecutive patients with suspected oral PV or MMP were enrolled. All patients underwent clinical examination, laboratory tests, intraoral UHFUS scan, and biopsy. Histology and direct immunofluorescence were set as benchmark for diagnosis confirmation. The sensitivity and specificity of UHFUS compared to histology were assessed. Mann-Whitney test was performed to evaluate the presence of differences in the echogenicity of PV and MMP. P-value was set at P < 0.05.Results: Twenty-five patients were included. Thirteen patients were diagnosed with PV, and twelve with MMP. The UHFUS features of PV and MMP lesions were described. Image analysis showed statistically significant differences between the echogenicity of PV and MMP lesions (P < 0.05). Good concordance between UHFUS and histology was found. UHFUS showed 75% sensitivity in the diagnosis of PV and 66.7% in the diagnosis of MMP.Conclusions: UHFUS appears a valuable tool in the diagnosis of PV and MMP.Although histology and immunofluorescence remain the gold standard, UHFUS role in the diagnostic algorithm of PV and MMP seems promising as a chair-side tool consistently enhancing clinical evaluation of oral bullous lesions.

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Intraoral ultrasonography in the assessment of DOI in oral cavity squamous cell carcinoma: a comparison with magnetic resonance and histopathology

Cited by 29 publications

References 37 publications

A comparative study between CT, MRI, and intraoral US for the evaluation of the depth of invasion in early stage (T1/T2) tongue squamous cell carcinoma

A comparative study between CT, MRI, and intraoral US for the evaluation of the depth of invasion in early stage (T1/T2) tongue squamous cell carcinoma

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

Ultra‐high frequency ultrasound in the differential diagnosis of oral pemphigus and pemphigoid: An explorative study

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