Transcervical Ultrasonography Research Articles

Comparison of Transoral and Transcervical Ultrasonography with MRI for the Diagnostic Work-Up of Oropharynx Tumors: A Protocol for a Multicenter Clinical Trial (SPOTUS).

This study protocol for a prospective, multicenter, diagnostic, clinical trial describes the integration of transoral and transcervical ultrasonography (US) in the initial clinical work-up of patients referred to tertiary head and neck cancer centers with suspected oropharyngeal cancer. The study evaluates the blinded detection rate of oropharyngeal tumors and their US-estimated size and T-stage before histopathology and cross-sectional imaging are available. Magnetic resonance imaging (MRI) scans will be prospectively rated while blinded to T-site histopathology and US. The primary outcome measures of diagnostic accuracy, including sensitivity, specificity, positive and negative predictive values, and overall accuracy, will be reported for both US and MRI. A sub-analysis of prospectively rated 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) scans in patients with clinically suspected unknown primary tumors will also be compared to US and MRI. Secondary outcome measures, including a comparison of tumor size estimation between US, MRI, and CT, will also be reported. This prospective multicenter study will provide clinically impactful information regarding the use of transoral and transcervical US for the diagnostic work-up of oropharyngeal cancer.

Advantages of otorhinolaryngologist performed transcervical ultrasonography in the management of peritonsillar abscess.

Peritonsillar abscess (PTA) is a very common infection, in particular in pediatric and adolescent population. A distinction between peritonsillar cellulitis and abscess should be made to determine the appropriate treatment. Nonetheless, the difference cannot always be made on physical examination alone and often requires imaging by computed tomography (CT). Radiation exposure as well as the cost and waiting time question the use of CT in this pathology. We present our experience in the use of Transcutaneous Cervical Ultrasonography for the diagnosis and management of peritonsillar abscess in the adult population. Clinical-prospective. Adult patients were evaluated for suspicion of PTA. Clinical findings were documented and all patients underwent a Transcutaneous Cervical Ultrasonography performed by a second otorhinolaryngology specialist well versed in Ultrasonography without knowing the clinical history, details of the physical examination, or the suspected side. Ultrasonography findings were later compared with the clinical examination and outcome of the medical or surgical management. Eight adult patients (range 18-53year-old) were enrolled in the study. Six of them, had, ultrasonography findings compatible with a peritonsillar liquid collection underwent surgical drainage that confirmed and drained an abscess. On two patients, the ultrasonography images described an aspect of peritonsillar cellulitis that was managed conservatively and showed a favorable remission. No complications during stay or side effects or intolerance to the ultrasound were recorded. Transcutaneous Cervical ultrasonography is a fast, useful tool, better tolerated than the intra-oral ultrasonography in diagnosing PTA. It avoids all irradiation exposure is much cheaper and the waiting time is shorter. Worth noting, is the richness of information pertaining the anatomy, vessels and abscess location and extension, for the surgeon performing the exam just prior to surgery. The efficiency and training of otorhinolaryngology specialists with this technique shows numerous promising benefits and deserves to be further developed.

Assessment of Tonsil Volume With Transcervical Ultrasonography in Both Children and Adults

To investigate the success of ultrasonography (USG) in the objective measurement of palatin tonsil volume in both children and adults and to compare those results with clinical findings. Eighty-five patients, who were scheduled to undergo tonsillectomy with the indications of recurrent tonsillitis and obstructive sleep apnea syndrome, were included in the study. The tonsil grades of the patients were recorded according to the Friedman tonsil grading. The tonsil size and volume were measured with transcervical USG. After tonsillectomy, the volumes of the tonsils were calculated by the displacement method. The correlation between the obtained data was evaluated. In all analyses, P < .05 was accepted as a statistical level of significance. Fifty children and 35 adults were included in the study. In children, the mean actual volume ± SD of 100 tonsils was measured as 3.5 ± 1.45 mL, and the USG volume was 3.67 ± 1.59 mL; a high correlation was found between both methods (r = 0.842; P < .05). In adults, the mean actual volume of 70 tonsils was measured as 5.15 ± 2.25 mL, and the USG volume was 5.71 ± 2.98 mL; a moderate correlation was found between the methods (r = 0.589; P < .05). In children, a moderate correlation was found between the Friedman grading and the USG (r = 0.532; P < .05), and actual (r = 0.549; P < .05) tonsil volumes. In adults, a low correlation was found between the Friedman grading and the USG (r = 0.363; P < .05) and actual (r = 0.384; P < .05) tonsil volumes. Ultrasonography is a useful, accessible, and noninvasive imaging method for objective measurement of tonsil volume in adults and children.

Evaluating oropharyngeal carcinoma with transcervical ultrasound, CT, and MRI

ObjectiveTo compare transcervical ultrasonography (US) to standard cross-sectional imaging for the visualization of human papillomavirus-related oropharyngeal cancer (HPV-OPC). Materials and methodsPatients with HPV-OPC and available standard imaging (CT and/or MRI) were identified in clinic and prospectively enrolled. US was performed to visualize the oropharynx and lymph nodes. Tumor characteristics across imaging modalities were evaluated (CT versus MRI, and US versus standard imaging (SI)). ResultsForty-three patients were included. The overall blinded detection rates for CT and MRI were 83% and 71%, respectively. The unblinded detection rate for US was 98%. Agreement of tumor anatomic subsite was moderate for both CT vs MRI (κ = 0.59) and US vs SI (κ = 0.47). Comparison of tumor size by CT and MRI showed statistically significant correlations in craniocaudal (CC), anteroposterior (AP), and mediolateral (ML) dimensions (RhoCC = 0.51, pCC = 0.038; RhoAP = 0.81, pAP < 0.0001; RhoML = 0.57, pML = 0.012). Tumor size estimates by US and SI showed statistically significant correlations in CC and AP, but not ML (RhoCC = 0.60, pCC = 0.003; RhoAP = 0.71, pAP < 0.0001; RhoML = 0.30, pML = 0.08). Tumor volume estimates improved correlations between US and SI (Rho = 0.66, p < 0.0001). Stratification of US patients into early and late imaging studies demonstrated an increase in correlation strength from early (Rho = 0.32, p = 0.32) to late groups (Rho = 0.77, p < 0.0001) demonstrating that ultrasound accuracy improved with experience. ConclusionsOur findings suggest that transcervical ultrasonography is a sensitive and relatively accurate adjunct to standard imaging for the evaluation of oropharyngeal tumors. Its cost, portability, and potential for in-clinic and serial imaging render US an attractive modality to further develop for imaging oropharyngeal tumors.

Transcervical ultrasonographic examination of palatine tonsil size and its correlation with age, gender and body-mass index in healthy children

ObjectiveOur aim was to assess the palatine tonsil size with transcervical ultrasonography in healthy children and to analyze whether the palatine tonsil size is correlated with age, gender and body-mass index (BMI). MethodsThis series consisted of 680 healthy children (340 females, 340 males) who underwent transcervical ultrasonography for evaluation of palatine tonsil size. A total of seventeen age groups (range: 1–17 years) comprised of 40 children (20 females, 20 males) were constituted. Demographic data including gender, height, weight and BMI were noted. Correlation between baseline descriptive data and tonsil volume was investigated. ResultsThe average age was 102.51 ± 59.24 months (range: 12 to 204) and body-mass index was 17.50–5.16 kg/m2 (min: 12.4-max:25.8). The average tonsil volume was 1819.5–2023.5 mm3 (min:601, max: 4007). The tonsil volume did not differ significantly between females and males (p = 0.108). However, there was a significant difference between tonsil volumes of various age groups (p < 0.001). Tonsil size seemed to be greater in parallel with advancement of age (p < 0.001) and increased BMI (p < 0.001). ConclusionTranscervical ultrasonography can be an accurate, safe, cheap, non-invasive and accessible measure for evaluation of the size of tonsils objectively. There were strongly positive correlations between age, BMI and palatine tonsil size in healthy children and variability with respect to descriptive characteristics must be considered during diagnostic procedures and preoperative evaluation. Advances in knowledgeIn our study, we suggest that transcervical ultrasonography can be an accurate, safe, cheap, non-invasive and accessible measure for evaluation of the size of tonsils. There were positive correlations between age, BMI and palatine tonsil size in healthy children.

Ultrasonographic measurement of palatine tonsil size and its correlation with body-mass index and hepatosteatosis in adolescents

Aim: To research the correlation between body-mass index (BMI) and hepatosteatosis with palatine tonsil size measured using transcervical ultrasonography (TCU) in adolescents.

Sonographic measurement of palatine tonsil volume in children and comparison with actual volume

Aim of this study is to compare the palatine tonsil (PT) volume measured with transcervical ultrasonography (TCU) in children with the actual volume to research the correlation with tonsillectomy indications. This prospective study included a total of 67 children, 37 boys and 30 girls, aged from 3-17 years who underwent bilateral tonsillectomy. Cases were divided into two groups based on tonsillectomy indications as chronic tonsillitis (Group 1) and obstructive sleep apnea syndrome (OSAS) (Group 2). The sonographic volume was measured with a 4.8-11.0 MHz linear transducer before tonsillectomy, while the actual volume was measured with the water displacement method. The correlation between both volume values was researched. Partial Correlation test was used to analyze correlations between variables after analysis of SPSS 22.0 program and age and gender factors. The mean ages in Groups 1 and 2 were 115.83±53.2 and 120.6±54.7 months, respectively. The actual and sonographic tonsil volumes in Group 1 were 2.03±0.82 ml and 2.22±0.85 ml (p=0.093), in Group 2 were 5.19±0.83 ml and 5.36±1.06 ml (p=0.074), respectively. In both groups the sonographic volume was correlated with the actual volume (r=0.788 and 0.829, respectively). The measured volumes with both methods were higher in Group 2 (p

Transcervical ultrasonography in the diagnosis of pediatric peritonsillar abscess.

Pediatric peritonsillar abscess (PTA) is a common infection, particularly in the adolescent population. Physical examination alone is not always sufficient to diagnose this pathology, and thus, computed tomography is often utilized as a diagnostic adjunct. With growing concern over radiation exposure in the pediatric population, we conducted a prospective study to investigate the use of ultrasonography in the detection of pediatric PTA. Prospective single arm cohort study. Pediatric patients examined in consultation for concern for PTA were prospectively enrolled in the study. Patients were managed based on clinical symptoms and presentation. Transcervical ultrasonography of the peritonsillar region was performed on all patients. Clinical outcomes were reviewed retrospectively and compared to ultrasound findings. Forty-three patients (age range, 2-20 years) were enrolled in the study. The sensitivity and specificity of transcervical ultrasound when compared to clinical outcomes were 100% and 76.5%, respectively. The positive and negative predictive values were 52.9% and 100%, respectively. Fisher exact test showed a statistically significant association (P < .01) between negative ultrasonography and successful medical management, and multivariate regression analysis showed a strong correlation between ultrasound findings and presence/absence of purulence during surgical intervention (P = .01). Transcervical ultrasonography is a useful tool in diagnosing pediatric PTA. This imaging modality not only avoids undue radiation exposure, but it also proves to be an excellent tool at identifying patients who will not need surgical intervention. To our knowledge, this is the first study to explore this technique for the diagnosis of pediatric PTA. 2b.

FRI0235 Static and Dynamic-Functional Trans-Cervical Ultrasonography of the Esophagus in Systemic Sclerosis Patients

BackgroundEsophagus is the second internal organ to be affected in systemic sclerosis (SSc), resulting in gastro-oesophageal reflux, oesophagitis and, in more advanced stages, complete atony with megaesophagus. Trans-cervical ultrasonography (TCU)...

Transcervical Ultrasonography Is Feasible to Visualize and Evaluate Base of Tongue Cancers

BackgroundBase of tongue (BOT) is a difficult subsite to examine clinically and radiographically. Yet, anatomic delineation of the primary tumor site, its extension to adjacent sites or across midline, and endophytic vs. exophytic extent are important characteristics for staging and treatment planning. We hypothesized that ultrasound could be used to visualize and describe BOT tumors.MethodsTranscervical ultrasound was performed using a standardized protocol in cases and controls. Cases had suspected or confirmed BOT malignancy. Controls were healthy individuals without known malignancy.Results100% of BOT tumors were visualized. On ultrasound BOT tumors were hypoechoic (90.9%) with irregular margins (95.5%). Ultrasound could be used to characterize adjacent site involvement, midline extent, and endophytic extent, and visualize the lingual artery. No tumors were suspected for controls.ConclusionsUltrasonography can be used to transcervically visualize BOT tumors and provides clinically relevant characteristics that may not otherwise be appreciable.

Transcervical Ultrasonography Is Feasible to Visualize and Evaluate Base of Tongue Cancers: Imaging

Transcervical Ultrasonography Is Feasible to Visualize and Evaluate Base of Tongue Cancers: Imaging