PT  - JOURNAL ARTICLE
AU  - B.C. Yoon
AU  - M.D. Bulbul
AU  - P.M. Sadow
AU  - W.C. Faquin
AU  - H.D. Curtin
AU  - M.A. Varvares
AU  - A.F. Juliano
TI  - Comparison of Intraoperative Sonography and Histopathologic Evaluation of Tumor Thickness and Depth of Invasion in Oral Tongue Cancer: A Pilot Study
AID  - 10.3174/ajnr.A6625
DP  - 2020 Jun 18
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2020/06/18/ajnr.A6625.short
4100  - http://www.ajnr.org/content/early/2020/06/18/ajnr.A6625.full
AB  - BACKGROUND AND PURPOSE: For primary squamous cell carcinoma of the oral tongue, accurate assessment of tumor thickness and depth of invasion is critical for staging and operative management. Currently, typical imaging modalities used for preoperative staging are CT and MR imaging. Intraoperatively, CT or MR imaging cannot provide real-time guidance, and assessment by manual palpation is limited in precision. We investigated whether intraoperative sonography is a feasible technique for assessment of tumor thickness and depth of invasion and validated its accuracy by comparing it with histopathologic evaluation of the resected specimen.MATERIALS AND METHODS: Twenty-six patients with squamous cell carcinoma of the oral tongue who underwent tumor resection by a single surgeon between March 31, 2016, and April 26, 2019, were prospectively identified. Intraoperative sonography was obtained in planes longitudinal and transverse to the long axis of the tumor. Twenty-two patients had archived images that allowed measurements of tumor thickness and depth of invasion sonographically. Two patients had dysplasia and were excluded. The remaining 20 patients had histologic tumor thickness and histologic depth of invasion measured by a single pathologist.RESULTS: The mean sonographic tumor thickness was 7.5  ± 3.5 mm, and the mean histologic tumor thickness was 7.0  ± 4.2 mm. Mean sonographic depth of invasion and histologic depth of invasion were 6.6  ± 3.4  and 6.4 ± 4.4 mm, respectively. There was excellent correlation between sonographic and histologic measurements for both tumor thickness and depth of invasion with Pearson correlation coefficients of 0.95 (95% CI, 0.87–0.98) and 0.95 (95% CI, 0.87–0.98), respectively.CONCLUSIONS: Intraoperative sonography can provide reliable, real-time assessment of the extent of tongue tumors.DOIdepth of invasionOTSCCoral tongue squamous cell carcinomaTTtumor thicknessuDOIultrasound-derived depth of invasionUSsonographyuTTultrasound-derived tumor thickness