Comparative assessment of the depth of invasion of early-stage oral cavity carcinomas based on intraoral ultrasound and computerized tomography findings

  • Biljana Marković Vasiljković University of Belgrade, Faculty of Dental Medicine, Center for Radiological Diagnostics, Belgrade, Serbia
  • Svetlana Antić University of Belgrade, Faculty of Dental Medicine, Center for Radiological Diagnostics, Belgrade, Serbia
  • Drago Jelovac University of Belgrade, Faculty of Dental Medicine, Belgrade, Serbia; Clinic for Maxillofacial Surgery, Belgrade, Serbia
Keywords: histological techniques, mouth neoplasms, neoplasm invasiveness, tomography, x-ray computed, ultrasonography

Abstract


 

Background/Aim. The depth of invasion of oral cavity carcinoma (OCC) and the nodal involvement define the treatment selection, outcome, and prognosis of the disease. In determining the stage of OCC, the most widely applied methods are computerized tomography (CT) and magnetic resonance imaging (MRI), whose limitations can be overcome to some extent by using intraoral ultrasound (IOUS). The aim of the study was to evaluate the imaging presentation of early-stage OCC, determine the depth of invasion (DOI) and the greatest diameter (GD) of the tumor using the IOUS and CT methods, and compare them with histopathological (HP) findings. Methods. The study was designed as a prospective one, with a time limitation of three months. Eleven patients with clinical early-stage OCC underwent a native CT examination of the head and neck as well as a contrast-enhanced phase, and then IOUS of the lesion was performed. Using both methods, DOI and GD values were measured, and the values were correlated with HP findings. The analysis of the obtained data was performed using the statistical package SPSS 22 and Pearson correlation coefficient. Results. A significant correlation (p = 0.001) was established between the DOI values measured by IOUS and CT examination with the measurements obtained by HP processing. On the other hand, by comparing the GD measured on IOUS and CT examination, no correlation was established with the HP report. Conclusion. Measurements of DOI obtained by IOUS significantly correlated with those in the HP report, while overcoming the limitations of the CT method in the evaluation of small-sized tumors and tumors that cannot be shown due to artifacts.

References

Bray F, Colombet M, Mery L, Piñeros M, Znaor A, Zanetti R, Ferlay J, editors. Cancer Incidence in Five Continents, Vol. XI. IARC Scientific Publication No. 166 [Internet]. Lyon (FR): International Agency for Research on Cancer; 2021 [accessed on 2023 Sept 20]. Available from: https://publications.iarc.fr/597

Irani S. New insights into oral cancer – Risk factors and pre-vention: A review of literature. Int J Prev Med 2020; 11: 202.

Subramaniam N, Poptani H, Schache A, Bhat V, Iyer S, Sunil HV, et al. Imaging advances in oral cavity cancer and perspectives from a population in need: Consensus from the UK-India oral cancer imaging group. J Head Neck Physicians Surg 2021; 9(1): 4–12.

Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, editors. AJCC Cancer Staging Manual. 7th ed. New York: Springer; 2010. p. 672.

Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK, et al., editors. AJCC Cancer Staging Manual. 8th ed. New York: Springer; 2017. p. 1032.

Lee YJ, Kwon TG, Kim JW, Lee ST, Hong SH, Choi SY. Evalua-tion of Depth of Invasion and Tumor Thickness as a Prog-nostic Factor for Early-Stage Oral Squamous Cell Carcinoma: A Retrospective Study. Diagnostics (Basel) 2021; 12(1): 20.

Izzetti R, Nisi M, Gennai S, Oranges T, Crocetti L, Caramella D, et al. Evaluation of Depth of Invasion in Oral Squamous Cell Carcinoma with Ultra-High Frequency Ultrasound: A Prelimi-nary Study. Appl Sci 2021; 11(16): 7647.

Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods 2009; 41(4): 1149–60.

Joshi PS, Pol J, Sudesh AS. Ultrasonography - A diagnostic mo-dality for oral and maxillofacial diseases. Contemp Clin Dent 2014; 5(3): 345–51.

Arya S, Chaukar D, Pai P. Imaging in oral cancers. Indian J Ra-diol Imaging 2012; 22(3): 195–208.

Tarabichi O, Bulbul MG, Kanumuri VV, Faquin WC, Juliano AF, Cunnane ME, et al. Utility of intraoral ultrasound in managing oral tongue squamous cell carcinoma: Systematic review. Laryngoscope 2019; 129(3): 662–70.

Yoon BC, Bulbul MD, Sadow PM, Faquin WC, Curtin HD, Varvares MA, et al. Comparison of Intraoperative Sonography and Histopathologic Evaluation of Tumor Thickness and Depth of Invasion in Oral Tongue Cancer: A Pilot Study. AJNR Am J Neuroradiol 2020; 41(7): 1245–50.

Brouwer de Koning SG, Karakullukcu MB, Lange CAH, Ruers TJM. The oral cavity tumor thickness: Measurement accuracy and consequences for tumor staging. Eur J Surg Oncol 2019; 45(11): 2131–6.

Weimar EAM, Huang SH, Lu L, O'Sullivan B, Perez-Ordonez B, Weinreb I, et al. Radiologic-Pathologic Correlation of Tumor Thickness and Its Prognostic Importance in Squamous Cell Carcinoma of the Oral Cavity: Implications for the Eighth Edition Tumor, Node, Metastasis Classification. AJNR Am J Neuroradiol 2018; 39(10): 1896–902.

Dirven R, Ebrahimi A, Moeckelmann N, Palme CE, Gupta R, Clark J. Tumor thickness versus depth of invasion - Analysis of the 8th edition American Joint Committee on Cancer Staging for oral cancer. Oral Oncol 2017; 74: 30–3.

Salama AM, Valero C, Katabi N, Khimraj A, Yuan A, Zanoni DK, et al. Depth of invasion versus tumour thickness in early oral tongue squamous cell carcinoma: which measurement is the most practical and predictive of outcome? Histopathology 2021; 79(3): 325–37.

Madana J, Laliberté F, Morand GB, Yolmo D, Black MJ, Mlynarek AM, et al. Computerized tomography-based tumor-thickness measurement is useful to predict postoperative pathological tumor thickness in oral tongue squamous cell carcinoma. J Otolaryngol Head Neck Surg 2015; 44: 49.

Klein Nulent TJW, Noorlag R, Van Cann EM, Pameijer FA, Wil-lems SM, Yesuratnam A, et al. Intraoral ultrasonography to measure tumor thickness of oral cancer: A systematic review and meta-analysis. Oral Oncol 2018; 77: 29–36.

Erdogan N, Bulbul E, Songu M, Uluc E, Onal K, Apaydin M, et al. Puffed cheek computed tomography: A dynamic maneuver for imaging oral cavity tumors. Ear Nose Throat J 2012; 91(9): 383-4, 386.

Marcello Scotti F, Stuepp RT, Leonardi Dutra-Horstmann K, Modolo F, Gusmão Paraiso Cavalcanti M. Accuracy of MRI, CT, and Ul-trasound imaging on thickness and depth of oral primary car-cinomas invasion: a systematic review. Dentomaxillofac Radiol 2022; 51(5): 20210291.

Published
2023/11/30
Section
Original Paper