Evaluation of Depth of Invasion in Oral Squamous Cell Carcinoma with Ultra-High Frequency Ultrasound: A Preliminary Study

Rossana Izzetti,Davide Caramella,Stefano Gennai,Teresa Oranges,Filippo Graziani,Laura Crocetti,Marco Nisi

doi:10.3390/app11167647

Abstract

Intraoral ultrasonography has been widely employed for the preoperative assessment of tumor margins due to its capability to evaluate depth of invasion (DOI) and tumor thickness (TT). Recently, a novel ultrasonographic technique, ultra-high frequency ultrasound (UHFUS) has been increasingly applied to the study of oral lesions. This study evaluates the potential application of intraoral UHFUS to assess DOI and TT parameters of oral squamous cell carcinoma (OSCC) lesions. Patients clinically suspected of OSCC lesions were enrolled and underwent an intraoral UHFUS examination preoperatively. The parameters of TT, DOI, echogenicity, and vascularization were assessed. The parameters of TT and DOI as evaluated by means of UHFUS were compared to histology, which was set as the benchmark. Ten patients in total were enrolled. UHFUS-based DOI and TT measurements were found to positively correlate with histology (p < 0.05), although UHFUS provided a slight overestimation of DOI. No differences were found in terms of echogenicity or vascularization depending on the site of the lesion. According to these preliminary results, UHFUS could support the preoperative assessment of TT and DOI, potentially enhancing the clinical evaluation of OSCC.

Highlights

In 6 patients, oral squamous cell carcinoma (OSCC) was localized in the tongue, while in 2 patients the lesions occurred in the mandibular gingival mucosa, in 1 patient in the buccal mucosa, and in 1 patient on the mouth floor
A minimal and clinically acceptable overestimation was found for ultra-high frequency ultrasound (UHFUS) depth of invasion (DOI) measurements, while
We might speculate that higher frequencies allowed better visualization of tumor margins, providing reliable measurements of the lesions’

Summary

Introduction

Oral squamous cell carcinoma (OSCC) is the most frequently encountered neoplasm of the oral cavity, accounting for 98% of all oral cancers [1]. OSCC predominantly affects males in the 6th decade (male/female ratio: 2.22:1) and is most frequently localized in the tongue [1]. Some environmental factors, such as smoking and alcohol consumption, have been claimed to have a role in OSCC development, at present the pathogenesis is unclear [2]. The prognosis is poor, with a survival rate of 57% at 5 years in patients >40 years of age, mostly due to late diagnosis when metastases have already developed [2]

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