Kaltoft Mikkel, Hahn Christoffer Holst, Wessman Marcus, Hansen Martin Lundsgaard, Agander Tina Klitmøller, Makouei Fatemeh, Wessel Irene, Todsen Tobias
Department of Oto-Rhino-Laryngology, Head- and Neck Surgery and Audiology Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.
Institute of Clinical Medicine, Faculty of Health Sciences, Copenhagen University, 2200 Copenhagen, Denmark.
Cancers (Basel). 2024 Feb 1;16(3):637. doi: 10.3390/cancers16030637.
Oral squamous cell carcinoma (OSCC) of the tongue is the most common type of oral cavity cancer, and tumor depth of invasion (DOI) is an important prognostic factor. In this study, we investigated the accuracy of intraoral ultrasound and magnetic resonance imaging (MRI) for assessing DOI in patients with OSCC. Histopathological measurement of DOI was used as a reference standard. We conducted a prospective study including patients planned for surgical treatment of OSCC in the tongue. The DOI was measured in an outpatient setting by intraoral ultrasound and MRI, and was compared to the histopathological DOI measurements. Bland-Altman analysis compared the mean difference and 95% limits of agreement (LOA) for ultrasound and MRI, and the Wilcoxon signed-rank test was used to test for significance. The correlation was evaluated using Pearson's correlation coefficient. We included 30 patients: 26 with T1 or T2 tumors, and 4 with T3 tumors. The mean difference from histopathology DOI was significantly lower for ultrasound compared to MRI (0.95 mm [95% LOA -4.15 mm to 6.06 mm] vs. 1.90 mm [95% LOA -9.02 mm and 12.81 mm], = 0.023). Ultrasound also led to significantly more correct T-stage classifications in 86.7% (26) of patients compared to 56.7% (17) for MRI, = 0.015. The Pearson correlation between MRI and histopathology was 0.57 ( < 0.001) and the correlation between ultrasound and histopathology was 0.86 ( < 0.001). This prospective study found that intraoral ultrasound is more accurate than MRI in assessing DOI and for the T-staging of oral tongue cancers. Clinical practice and guidelines should implement intraoral ultrasound accordingly.
舌部口腔鳞状细胞癌（OSCC）是口腔癌最常见的类型，肿瘤浸润深度（DOI）是一个重要的预后因素。在本研究中，我们调查了口腔超声和磁共振成像（MRI）评估OSCC患者DOI的准确性。DOI的组织病理学测量用作参考标准。我们进行了一项前瞻性研究，纳入计划接受舌部OSCC手术治疗的患者。在门诊环境中通过口腔超声和MRI测量DOI，并与组织病理学DOI测量结果进行比较。Bland-Altman分析比较了超声和MRI的平均差异及95%一致性界限（LOA），并使用Wilcoxon符号秩检验进行显著性检验。使用Pearson相关系数评估相关性。我们纳入了30例患者：26例为T1或T2期肿瘤，4例为T3期肿瘤。与MRI相比，超声测量结果与组织病理学DOI的平均差异显著更低（0.95毫米[95% LOA -4.15毫米至6.06毫米] vs. 1.90毫米[95% LOA -9.02毫米至12.81毫米]，P = 0.023）。与MRI的56.7%（17例）相比，超声还使86.7%（26例）的患者T分期分类更正确，P = 0.015。MRI与组织病理学之间的Pearson相关性为0.57（P < 0.001），超声与组织病理学之间的相关性为0.86（P < 0.001）。这项前瞻性研究发现，口腔超声在评估DOI和口腔舌癌的T分期方面比MRI更准确。临床实践和指南应相应地采用口腔超声。
