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Lo WC, Chang CM, Cheng PC, Wen MH, Wang CT, Cheng PW, Liao LJ. The Applications and Potential Developments of Ultrasound in Oral Cancer Management. Technol Cancer Res Treat 2022; 21:15330338221133216. [PMID: 36254559 PMCID: PMC9580086 DOI: 10.1177/15330338221133216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Oral cancer is endemic and causes a great burden in Southern Asia. It is preferably treated by surgery with/without adjuvant radiotherapy (RT) or chemoradiation therapy, depending on the stage of the disease. Close or positive resection margin and cervical lymph node (LN) metastasis are important prognostic factors that have been presented to be related to undesirable locoregional recurrence and poor survival. Ultrasound (US) is a simple, noninvasive, time-saving, and inexpensive diagnostic modality. It can depict soft tissues very clearly without the risk of radiation exposure. Additionally, it is real-time and continuous image is demonstrated during the exam. Furthermore, the clinician can perform US-guided fine needle aspiration (FNA) or core needle biopsy (CNB) at the same time. US with/without US-guided FNA/CNB is reported to be of value in determining tumor thickness (TT), depth of invasion (DOI), and cervical LN metastasis, and in aiding the staging of oral cancer. DOI has a relevant prognostic value as reported in the eighth edition of the American Joint Committee on Cancer staging of oral cancer. In the present review, we describe the clinical applications of US in oral cancer management in different phases and potential applications in the future. In the pretreatment and surgical phase, US can be used to evaluate TT/DOI and surgical margins of oral cancer in vivo and ex vivo. The prediction of a malignant cervical LN (nodal metastasis) by the US-based prediction model can guide the necessity of FNA/CNB and elective neck dissection in clinical early-stage oral cancer. In the posttreatment surveillance phase, US with/without US-guided FNA or CNB is helpful in the detection of nodal persistence or LN recurrence, and can assess the possibility and extent of carotid artery stenosis after irradiation therapy. Both US elastography and US swallowing assessment are potentially helpful to the management of oral cancer.
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Affiliation(s)
- Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Graduate Institute of Medicine, Yuan Ze University, Taoyuan,Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City
| | - Chih-Ming Chang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Department of Biomedical Engineering, National Yang-Ming University, Taipei
| | - Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City,Department of Biomedical Engineering, National Yang-Ming University, Taipei,Department of Communication Engineering, Asia Eastern University of Science and Technology, New Taipei City
| | - Ming-Hsun Wen
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei
| | - Chi-Te Wang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Department of Electrical Engineering, Yuan Ze University, Taoyuan
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City,Department of Electrical Engineering, Yuan Ze University, Taoyuan,Li-Jen Liao, MD, PhD, Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Banqiao, New Taipei 22061.
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Jiang H, Tan Q, He F, Yang W, Liu J, Zhou F, Zhang M. Ultrasound in patients with treated head and neck carcinomas: A retrospective analysis for effectiveness of follow-up care. Medicine (Baltimore) 2021; 100:e25496. [PMID: 33879682 PMCID: PMC8078385 DOI: 10.1097/md.0000000000025496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 03/15/2021] [Indexed: 02/05/2023] Open
Abstract
Correct follow-up is necessary to avoid under- or overtreatment in the care of patients with treated carcinomas of head and neck. Ultrasound is a cost-effective, harmless, easy, and feasible method. It can be applied in the outpatient clinic in follow-up but the United Kingdom National Multidisciplinary guidelines are recommended computed tomography or magnetic resonance imaging for the detection of metastasis for head and neck carcinomas in the follow-up period. The purpose of the study was to state that neck ultrasound would be the method of choice on follow-up care of Chinese patients who received primary treatment for carcinoma of head and neck.Patients who received primary treatment for carcinoma of the head and neck were examined for 5-years in follow-up through physical, clinical, and neck ultrasound (n = 198). If patients had no evidence of disease after 60 months of definitive therapy considered as a cure. If patients had no evidence of disease after 36 months of salvage therapy considered as a cure of recurrence.Irrespective of definitive treatment used, the study was monitored through neck ultrasound during 5 years of a follow-up visit and was reported cure in 126 (64%) patients and recurrence in 72 (36%; distant metastasis: 33 [17%], local recurrence: 24 [12%], and regional recurrence: 15 [7%]) patients. Primary tumor stage IV, III, II, and I had 63% (15/24), 51% (21/41), 32% (18/56), and 23% (18/77) recurrence, respectively. The time to detect regional recurrence was shorter than that for local recurrence (P < .0001, q = 15.059) and distant recurrence (P < .0001, q = 7.958). Local recurrence and stage I primary tumor had the highest percentage cure for recurrence.Neck ultrasound in the follow-up period is reported to be effective for the detection of recurrence of patients who received primary treatment for carcinoma of head and neck especially regional recurrence and primary tumor stage I.Level of Evidence: III.
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Affiliation(s)
- Hongying Jiang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University
- Key Laboratory of Rehabilitation Medicine in Sichuan Province
- West China School of Nursing, West China Hospital, Sichuan University
| | - Qiling Tan
- West China School of Nursing, West China Hospital, Sichuan University
| | - Fawei He
- Department of Ultrasound, Sichuan Cancer Hospital
| | - Wei Yang
- Department of Ultrasound, Sichuan Cancer Hospital
| | - Jifeng Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu
| | - Fang Zhou
- Department of Oncology, Gong’an County People's Hospital, Gong’an, Hubei, China
| | - Mingxia Zhang
- Department of Oncology, Gong’an County People's Hospital, Gong’an, Hubei, China
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Yamada I, Yohino N, Yokokawa M, Oikawa Y, Harada H, Hikishima K, Kurabayashi T, Saida Y, Tateishi U, Ohata Y. Diffusion tensor imaging of oral carcinoma: Clinical evaluation and comparison with histopathological findings. Magn Reson Imaging 2020; 77:99-108. [PMID: 33373694 DOI: 10.1016/j.mri.2020.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 11/15/2020] [Accepted: 12/20/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aims to assess the usefulness of diffusion tensor imaging (DTI) as a noninvasive method for the evaluation of histological grade and lymph node metastasis in patients with oral carcinoma (OC). MATERIALS AND METHODS Thirty-six consecutive patients with histologically confirmed OC underwent examination by 3-T MRI. DTI was performed using a single-shot echo-planar imaging sequence with b values of 0 and 1000 s/mm2 and motion-probing gradients in 12 noncollinear directions. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) maps were compared with histopathological findings. The DTI parameters were correlated with the histological grade of the OCs based on the World Health Organization grading criteria and the presence or absence of lymph node metastasis. RESULTS The FA values (0.275 ± 0.058) of OC were significantly lower than those of normal tongue, muscle, and parotid glands (P < 0.001 for all), and the MD, AD, and RD values (1.220 ± 0.149, 1.434 ± 0.172, and 1.019 ± 0.165 × 10-3 mm2/s, respectively) were significantly higher than their respective normal values (P < 0.001 for all). Significant inverse correlations with histological grades were shown for FA, MD, AD, and RD values in OC patients (r = -0.862, r = -0.797, r = -0.747, and r = -0.844, respectively; P < 0.001 for all). In addition, there was a significant difference in the FA values of metastatic and nonmetastatic lymph nodes (0.186 vs. 0.276), MD (0.923 vs. 1.242 × 10-3 mm2/s), AD (1.246 vs. 1.621 × 10-3 mm2/s), and RD (0.792 vs. 1.100 × 10-3 mm2/s; P < 0.001 for all). CONCLUSIONS DTI may be clinically useful for the noninvasive evaluation of histological grade and lymph node metastasis in OC patients.
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Affiliation(s)
- Ichiro Yamada
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Norio Yohino
- Department of Oral and Maxillofacial Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Misaki Yokokawa
- Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Oikawa
- Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keigo Hikishima
- Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
| | - Tohru Kurabayashi
- Department of Oral and Maxillofacial Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukihisa Saida
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yae Ohata
- Department of Oral Pathology, Tokyo Medical and Dental University, Tokyo, Japan
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Yamada I, Yoshino N, Hikishima K, Sakamoto J, Yokokawa M, Oikawa Y, Harada H, Kurabayashi T, Saida Y, Tateishi U, Yukimori A, Izumo T, Asahina S. Oral carcinoma: Clinical evaluation using diffusion kurtosis imaging and its correlation with histopathologic findings. Magn Reson Imaging 2018; 51:69-78. [DOI: 10.1016/j.mri.2018.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 12/26/2022]
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Sawant SS, Dongre H, Ahire C, Sharma S, Kannan S, Mahadik S, Chaukar D, Lukmani F, Patil A, D'Cruz A, Vaidya MM, Dongre P. A nomogram for predicting the risk of neck node metastasis in pathologically node-negative oral cavity carcinoma. Oral Dis 2017; 23:1087-1098. [PMID: 28580710 DOI: 10.1111/odi.12696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/08/2017] [Accepted: 05/23/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To generate a nomogram for predicting the risk of neck node metastasis in pathologically node-negative patients using a combination of variables comprising of protein expression, ultrastructural alterations and clinicopathological parameters. MATERIALS AND METHODS Surgically removed oral tumours (n = 103) were analysed for the expression of desmosomal and hemidesmosomal assembly proteins by immunohistochemistry and ultrastructural alterations by transmission electron microscopy (TEM). Protein expression, ultrastructural alterations and clinicopathological variables were used to construct nomogram from the training set in 75 patients. Clinical utility of the nomogram was validated in a discrete set of 28 patients. RESULTS Univariate and multivariate analyses were performed on the training set, and obtained significant variables comprising of integrin β4 expression (p = .027), number of hemidesmosomes (p = .027)/desmosomes (p = .046), tumour differentiation grade (p = .033) and tumour thickness (p = .024) were used for construction of the nomogram. The area under the curve was calculated for both training 0.821 (95% CI 0.725-0.918) and validation sets 0.880 (95% CI 0.743-1.000). The nomogram demonstrated a predictive accuracy of 73.3% and 78.6% with the sensitivity of 81.4% and 83.3% in the training and validation sets, respectively. CONCLUSIONS The nomogram constructed on postsurgical tumour samples will be a value addition to histopathology for the detection of neck node metastasis in pathologically node-negative patients.
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Affiliation(s)
- S S Sawant
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - H Dongre
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - C Ahire
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - S Sharma
- Oral Surgery Head and Neck Unit, Tata Memorial Hospital (TMH), Mumbai, Maharashtra, India
| | - S Kannan
- Epidemiology and Clinical Trials Unit, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Mumbai, Maharashtra, India
| | - S Mahadik
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - D Chaukar
- Oral Surgery Head and Neck Unit, Tata Memorial Hospital (TMH), Mumbai, Maharashtra, India
| | - F Lukmani
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - A Patil
- Department of Pathology, Tata Memorial Hospital (TMH), Mumbai, Maharashtra, India
| | - A D'Cruz
- Oral Surgery Head and Neck Unit, Tata Memorial Hospital (TMH), Mumbai, Maharashtra, India
| | - M M Vaidya
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - P Dongre
- Department of Biophysics, University of Mumbai, Mumbai, Maharashtra, India
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