Intraoral ultrasonography in the assessment of DOI in oral cavity squamous cell carcinoma: a comparison with magnetic re
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HEAD AND NECK
Intraoral ultrasonography in the assessment of DOI in oral cavity squamous cell carcinoma: a comparison with magnetic resonance and histopathology Marta Filauro1,2,3 · Francesco Missale1,4 · Filippo Marchi1,3 · Andrea Iandelli1 · Andrea Luigi Camillo Carobbio1,2 · Francesco Mazzola1,2 · Giampiero Parrinello1 · Emanuele Barabino1,5 · Giuseppe Cittadini1,5 · Davide Farina6 · Cesare Piazza7 · Giorgio Peretti1,2 Received: 8 September 2020 / Accepted: 5 October 2020 © The Author(s) 2020
Abstract 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 c DOIMR and pDOI values of 0.2 mm (95% CI − 1.0–1.3 mm) and between c DOIIOUS and pDOI of 0.3 mm (95% CI − 1.0–1.6 mm). Spearman R between c DOIMR 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-off of 5 mm, of patients with a pDOI ≥ 4 mm and amenable to a neck dissection, with an AUC of 0.92 and 0.82 for MR and IOUS, respectively. Conclusion Both examinations were valid approaches for preoperative determination of DOI in OCSCC, although with different cost-effectiveness profiles and indications. Keywords Mouth · Neoplasm · Magnetic resonance imaging · Ultrasonography · Depth of invasion · Head and neck
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00405-020-06421-w) contains supplementary material, which is available to authorized users. * Andrea Luigi Camillo Carobbio [email protected] 1
IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132 Genoa, Italy
Interdisciplinary Department of Surgical and Integrated Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy
2
3
Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
Head and neck cancer is the 6th most common malignancy worldwide, and oral cavity tumors account for nearly onethird of the tumors [1]. Squamous cell carcinoma (SCC) is the most frequent histotype: it usually arises in the mobile tongue, followed by the lip, floor of the mouth, and buccal 4
Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
5
Department of Diagnostic Radiology, IRCCS Policlinico San Martino, Genoa, Italy
6
Department of Radiology, University of Brescia, Brescia, Italy
7
Department of Otorhin
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