Evaluation of Depth of Invasion in Oral Squamous Cell Carcinoma with Ultra-High Frequency Ultrasound: A Preliminary Study (original) (raw)
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Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2021
Objective. The aim of this study was to evaluate the efficacy of preoperative intraoral ultrasonography (US) in the assessment of tumor depth of invasion (DOI) in oral squamous cell carcinoma (OSCC). Study Design. Records of 32 patients with biopsy-proven OSCC who underwent preoperative intraoral US were retrospectively reviewed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy as indicated by receiver operating characteristic (ROC) analysis were measured for US in the assessment of the infiltration of the tumor beyond the lamina propria into the submucosa. The correlations between US and histologic DOI, and between US DOI and US diameter of the lesion, were assessed. Results. US sensitivity, specificity, PPV, and NPV in the assessment of the infiltration of the tumor beyond the lamina propria into the submucosa were 93.1%, 100%, 100%, and 60%, respectively. The area under the ROC curve was 0.96. A significant correlation was found between the measurements of US DOI and histological DOI (r = 0.907). A moderate correlation was found between US DOI and US diameter (r = 0.591). Conclusions. Intraoral US has potential in preoperatively determining tumor DOI and may provide additional guidance for optimal planning of therapy for OSCC patients. (Oral Surg Oral Med Oral Pathol Oral Radiol 2020;000:1À9)
International Journal of Environmental Research and Public Health
The eighth edition of the TNM classification officially introduced “depth of invasion” (DOI) as a criterion for determining the T stage in tongue squamous cell carcinoma. The DOI is a well-known independent risk factor for nodal metastases. In fact, several experts strongly suggest elective neck dissection for tongue cancer with a DOI > 4 mm due to the high risk of early and occult nodal metastases. Imaging plays a pivotal role in preoperative assessments of the DOI and, hence, in planning the surgical approach. Intraoral ultrasound (IOUS) has been proposed for early-stage SCC of the oral tongue as an alternative to magnetic resonance imaging (MRI) for local staging. The aim of this work is to investigate the accuracy of IOUS in the assessment of the DOI in early oral SCC (CIS, pT1, and pT2). A total of 41 patients with tongue SCCs (CIS-T2) underwent a preoperative high-frequency IOUS. An IOUS was performed using a small-size, high-frequency hockey-stick linear probe. The ultraso...
European Archives of Oto-Rhino-Laryngology, 2020
Objective The first-line therapeutic approach for oral cavity squamous cell carcinoma (OCSCC) is complete surgical resection. Preoperative assessment of depth of invasion (cDOI) is crucial to plan the surgery. Magnetic resonance (MR) and intraoral ultrasonography (IOUS) have been shown to be useful tools for assessment of DOI. The present analysis investigates the accuracy of MR and IOUS in evaluating DOI in OCSCC compared to histological evaluation (pDOI). Materials and methods Forty-nine previously untreated patients with cT1-T3 OCSCC were reviewed. Nine patients were staged with MR alone, 10 with IOUS alone, and 30 with both MR and IOUS. Results Mean difference between cDOIMR and pDOI values of 0.2 mm (95% CI − 1.0–1.3 mm) and between cDOIIOUS and pDOI of 0.3 mm (95% CI − 1.0–1.6 mm). Spearman R between cDOIMR and pDOI was R = 0.83 and between cDOIIOUS and pDOI was R = 0.76. Both radiological techniques showed high performance for the correct identification, with the optimum cut-...
Oral Oncology, 2018
Early oral cancer is preferably treated by surgery. Its complete removal is essential for locoregional control and disease-free survival. Inadequate resection margins require adjuvant therapy such as re-resection or (chemo) radiation, that causes extra morbidity and oral discomfort. Intraoral ultrasonography (US) is reported to be of value in determining tumor thickness. Intraoperative visualization of the tumor may facilitate the resection and ensure adequate surgical margins. Furthermore, accurate prediction of tumor thickness could help determine the treatment strategy of the clinically node-negative neck, as thickness and depth of invasion are predictors of cervical metastasis as well as prognosticators of survival. The 8th edition of the American Joint Committee on Cancer staging system for oral squamous cell carcinoma has included depth of invasion as parameter for cTstage. The aim of this review is to analyze the accuracy of intraoral US in determining tumor thickness in oral cancer. A systematic search was conducted, and the quality of the included papers was assessed using the QUADAS-2 tool for diagnostic accuracy studies. Subsequently, a meta-analysis was performed on the available individual participant data of 240 patients. Most of the twelve included studies focused on T1-2 tongue cancer (n = 129). Meta-analysis showed a high correlation in tumor thickness within this subgroup as measured by intraoral US and histopathology (r = 0.82, p < .001), with minor overestimation of 0.5 mm on US. It is concluded that intraoral US is very accurate in determining tumor thickness in early oral tongue cancer.
Preoperative measurement of tumor thickness of oral tongue carcinoma with intraoral ultrasonography
Head & Neck, 2008
Background. Tumor thickness of oral tongue carcinoma is an important independent prognostic factor for local recurrence, subclinical nodal metastasis, and survival. An accurate preoperative assessment of tumor thickness is therefore essential in optimizing treatment algorithm. The present study aims at evaluating the accuracy of intraoral ultrasonography in preoperative measurement of tumor thickness.
Cancers
High-definition ultrasonography is a diagnostic tool that uses sound echoes to produce images of tissues and organs. In the head and neck region, ultrasounds have been used to diagnose different types of lesions. The intraoral approach was shown to be a real-time, non-invasive way to characterize oral lesions. The tongue is the most often examined region because of its accessibility. This observational study aimed to describe the qualitative characteristics of tongue squamous cell carcinoma images obtained with high-definition intraoral ultrasound by comparing them with the corresponding histopathological sample. Twenty patients were enrolled in this study. The scans of the lesions were carried out with an 18 MHz linear ultrasound probe following the long axis of the lesion. For each lesion, five frames were selected, on which descriptive analysis was performed. A histological sample was taken and then compared to the ultrasonographic acquisition. The sonographic appearance of the t...
Head and Neck Pathology, 2019
Depth of invasion (DOI) and tumour thickness (TT) are known prognostic indicators in oral squamous cell carcinoma (OSCC), but varying definitions have been used by pathologists for reporting. The American Joint Committee on Cancer (AJCC) has proposed adoption of a uniform definition of DOI and incorporated this measurement in the revised TNM staging (8th edition); however, unambiguous DOI determination can be a challenge in clinical practice. We reviewed archived slides of 95 cases of T1/T2N0 OSCC and listed the challenges in accurate DOI measurement with pictographical documentation. The impacts of DOI and TT on disease-free survival (DFS) were also assessed. The mean DOI and TT was 5.89 mm and 7.32 mm respectively. Challenge in horizon estimation for DOI measurement was experienced in 75/95 cases (78.9%). The most common challenges were lack of adjacent uninvolved mucosa in sections or presence only on one side, rounded/ convoluted nature of the tumour surface for tongue and polypoidal tumours, and angulation of adjacent mucosa for alveolar or lip tumours. In cases with very thin epithelium, DOI was equal to TT. In spite of the challenges, Kaplan-Meier analysis showed DOI > 5 mm significantly predicted poorer DFS while TT did not. We recommend various guidelines to help improve consistency in measuring DOI and recording of TT in ambiguous cases for accurate staging of OSCC.
Cureus
Background Depth of invasion (DOI) is a known indicator of metastatic potential in oral cavity squamous cell carcinoma (SCC). Our purpose was to investigate the accuracy of preoperative determination of DOI in oral cavity SCC by computed tomography (CT) and positron emission tomography/computed tomography (PET/CT). Methodology A retrospective study was performed using consecutive patients with histologically proven oral cavity SCC presenting to our otorhinolaryngology department between January 2014 and July 2019 who underwent preoperative contrast-enhanced CT and/or PET/CT. Pathological assessment of DOI was determined by a review of pathology reports. The degree of DOI determined by radiographic studies was correlated to pathology results. Results A total of 79 patients were screened of whom appropriate radiographic studies were available for 63 patients.