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

Imaging the Micron: New Directions in Diagnosis with Ultra-High-Frequency Ultrasound

In recent decades, advancements in medical imaging technologies have revolutionized diagnostic and therapeutic approaches, enhancing the precision and efficacy of healthcare interventions [...].

Can High-Frequency Intraoral Ultrasound Predict Histological Risk Factors in Oral Squamous Cell Carcinoma? A Preliminary Experience

Despite advancements in multidisciplinary care, oncologic outcomes of oral cavity squamous cell carcinoma (OSCC) have not substantially improved: still, one-third of patients affected by stage I and II can develop locoregional recurrences. Imaging plays a pivotal role in preoperative staging of OSCC, providing depth of invasion (DOI) measurements. However, locoregional recurrences have a strong association with adverse histopathological factors not included in the staging system, and any imaging features linked to them have been lacking. In this study, the possibility to predict histological risk factors in OSCC with high-frequency intraoral ultrasonography (IOUS) was evaluated. Thirty-four patients were enrolled. The agreement between ultrasonographic and pathological DOI was evaluated, and ultrasonographic margins' appearance was compared to the Brandwein-Gensler score and the worst pattern of invasion (WPOI). Excellent agreement between ultrasonographic and pathological DOI was found (mean difference: 0.2 mm). A significant relationship was found between ultrasonographic morphology of the front of infiltration and both Brandwein-Gensler score ≥ 3 (p < 0.0001) and WPOI ≥4 (p = 0.0001). Sensitivity, specificity, positive predictive value, and negative predictive value for the IOUS to predict a Brandwein-Gensler score ≥3 were 93.33%, 89.47%, 87.50%, and 94.44%, respectively. The present study demonstrated the promising role of IOUS in aiding risk stratification for OSCC patients.

Accuracy of magnetic resonance imaging in the assessment of depth of invasion in tongue carcinoma: A systematic review and meta-analysis

Tongue carcinoma constitutes 10.4-46.9% of all oral squamous cell carcinomas (OSCCs) and is notoriously known for invading tissues deeper than the evident gross margins. The deeper the tumor invades, the higher are its chances of future morbidity and mortality due to extensive neck dissection and risk of recurrence. Magnetic resonance imaging (MRI) is a noninvasive diagnostic aid used for measuring a preoperative tumor's depth of invasion (DOI) as it can efficiently outline soft tissue tumors from adjacent normal tissue. To assess various MRI modalities used in measuring DOI in tongue carcinoma and their reliability compared with other DOI measuring modalities. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022330866), and the following Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) Diagnostic Test Accuracy guidelines were performed. PubMed electronic database was searched using a combination of keywords for relevant articles in the English language since 2016. Critical appraisal was carried out using the Quality Assessment of Diagnostic Accuracy Studies-Comparative (QUADAS-C) risk-of-bias (RoB) assessment tool. A weighted mean difference (WMD) was calculated between MRI and histopathological DOI along with pooled correlation and subgroup analysis, where possible. A total of 795 records were retrieved of which 17 were included in the final review with 13 included for meta-analysis. A high RoB was found for most studies for all parameters except flow and timing. WMD showed a statistically significant MRI overestimation of 1.90 mm compared with histopathology. Subgroup analysis showed the 1.5 Tesla machine to be superior to the 3.0 Tesla machine, while imaging sequence subgroup analysis could not be performed. MRI is a viable preoperative DOI measurement modality that can help in efficient treatment planning to decrease surgical morbidity and mortality.

The Reliability of Ultrasonographic Assessment of Depth of Invasion: A Systematic Review with Meta-Analysis

Depth of invasion (DOI) has been recognized to be a strong prognosticator for oral squamous cell carcinoma (OSCC). Several diagnostic techniques can be employed for DOI assessment, however intraoral ultrasonography has been increasingly applied for the intraoral evaluation of OSCCs. The aim of the present study is to review the evidence on the application of intraoral ultrasonography to the assessment of DOI in patients affected by OSCC. A systematic electronic and manual literature search was performed, and data from eligible studies were reviewed, selected, and extracted. The studies had to report the correlation between DOI estimated with ultrasonography versus histopathology. A meta-analysis was conducted on the quantitative data available. Sixteen articles were included in the review following the screening of the initial 228 studies retrieved from the literature. The meta-analysis showed a significant correlation between ultrasonographic and histopathologic measurements (p < 0.01). The studies were all at low/moderate risk of bias. Ultrasonography appears a valuable tool for DOI assessment.

Special Issue on Materials and Technologies in Oral Research

The introduction of novel materials and technologies in oral research has permitted the rapid evolution of dentistry, as confirmed by the increasing number of publications on this topic [...]

Bilateral Cervical Lymphadenopathy after mRNA COVID-19 Vaccination on Oral Squamous Cell Carcinoma Patient: A Case Report

We report the case of a 59-year-old man with squamous cell carcinoma (SCC) of the right mandibular gingiva, who presented with bilateral cervical lymphadenopathy (CLA) after mRNA coronavirus disease 2019 (COVID-19) vaccination. The patient was diagnosed. Imaging studies performed prior to surgery revealed bilateral CLA and axillary lymphadenopathy (LA) ipsilateral to the vaccination site. Fine-needle aspiration (FNA) biopsy of the left CLA revealed reactive lymph nodes. The patient underwent surgical intervention for the malignant tumor, and the specimen was sent for histopathologic evaluation. The biopsy-proven cancer stage was pT3N0Mx. Positron emission tomography (PET-CT), performed six months after surgery, showed persistent bilateral CLA. However, FNA of the left axillary LA once again showed no evidence of metastasis or recurrence. Since the treatment plan may change based on the type of LA, it is important to figure out whether an mRNA vaccine has been administered to patients with head and neck cancer.