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Bhuyan G, Hazarika P, Rabha AM. Evaluation of the significance of tumor stromal patterns and peri-tumoral inflammation in head and neck squamous cell carcinoma with special reference to the Yamamoto-Kohama classification. INDIAN J PATHOL MICR 2024; 67:340-348. [PMID: 38427768 DOI: 10.4103/ijpm.ijpm_426_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/26/2023] [Indexed: 03/03/2024] Open
Abstract
INTRODUCTION Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with 878,348 new cases. Cancer-associated fibroblasts (CAFs) are the predominant cell type in tumor stroma and are important promoters of tumor progression. OBJECTIVE The aim of the study was to evaluate the pattern of desmoplastic stromal reaction and peri-tumoral inflammatory infiltrate with the histological grade and clinical data. MATERIALS AND METHODS A total of 60 cases of HNSCC were included in the study. The hematoxylin and eosin (H and E)-stained sections from all cases were examined by two experienced pathologists for the grade, nature of stomal reaction (SR), peri-tumoral inflammatory infiltration, Yamamoto-Kohama classification grade, worst pattern of invasion (WPOI), depth of invasion (DOI), and other histopathological parameters. Correlation analysis was conducted using the Chi-square test. P- value less than 0.05 was considered statistically significant. RESULTS Immature SR was not observed in any of the well-differentiated squamous cell carcinoma (SCC) cases. However, one (3.7%) case of moderately differentiated SCC and two (28.6%) cases of poorly differentiated SCC showed signs of immature SR. In the case of the higher grades of the YK classification, specifically grades 4C and 4D, a more profound depth of tumor cell invasion, equal to or exceeding 10 mm, was evident in six (66.67%) and two (28.57%) cases, respectively. Additionally, among the seven (11.7%) cases classified as poorly differentiated carcinoma, three (42.85%) displayed a WPOI score of 5. CONCLUSION SR and the tumor invasive pattern in HNSCC are related to prognosis and may indicate tumor aggressiveness.
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Affiliation(s)
- Geet Bhuyan
- Department of Pathology, Jorhat Medical College and Hospital, Jorhat, Assam, India
| | - Prabir Hazarika
- Department of Pathology, Tezpur Medical College and Hospital, Jorhat, Assam, India
| | - Anju M Rabha
- Department of Pathology, Tezpur Medical College and Hospital, Jorhat, Assam, India
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Pires Duarte LC, Teixeira K, Dias BMF, Fonseca FP, Travassos DV, Smit C, Castro MAAD, Sampaio AA. Ultrasonography use for tongue cancer management: A scoping review. J Oral Pathol Med 2024; 53:107-113. [PMID: 38355113 DOI: 10.1111/jop.13515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/27/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Tongue cancer is associated with debilitating diseases and poor prognostic outcomes. The use of imaging techniques like ultrasonography to assist in the clinical management of affected patients is desirable, but its reliability remains debatable. Therefore, the aim of this study is to investigate the importance of ultrasound use for the clinicopathological management of tongue cancer. METHODS A scoping review was carried out using specific search strategies in the following electronic databases: PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. Collected data included bibliographical information, study design, ultrasound equipment, the aim of the ultrasonography use, the timing of ultrasound use during oncological treatment (pre-, trans-, and/or post-operatively), and the advantages and disadvantages of the use of the ultrasound. RESULTS A total of 47 studies were included in this review after following the selection process. The majority of the studies investigated the use of ultrasound pre-operatively for the investigation of lymph node metastases or to determine the tumor thickness and depth of invasion. The sensitivity, specificity, and accuracy of ultrasound to determine clinical lymph node metastases ranged from 47% to 87.2%, from 84.3% to 95.8%, and from 70% to 86.2%, respectively. The sensitivity and specificity to determine the microscopic depth of invasion were 92.3% and from 70.6% to 82.1%, respectively. CONCLUSION Ultrasonography seems to be a reliable imaging technique for the investigation of important prognostic parameters for tongue cancer, including depth of invasion and lymph node metastases.
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Affiliation(s)
- Luiz Cláudio Pires Duarte
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Karlayle Teixeira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Denise Vieira Travassos
- Department of Public Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Chané Smit
- Department of Oral and Maxillofacial Pathology, University of Pretoria, Pretoria, South Africa
| | | | - Aline Araujo Sampaio
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Qi B, Khazeinezhad R, Hariri A, Yim W, Jin Z, Sasi L, Chen C, Jokerst JV. Three-dimensional mapping of the greater palatine artery location and physiology. Dentomaxillofac Radiol 2023; 52:20230066. [PMID: 37641889 DOI: 10.1259/dmfr.20230066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE To develop a novel technique for localizing and reconstructing the greater palatine artery (GPA) using three-dimensional (3D) technology. METHODS A miniaturized intraoral ultrasound transducer was used to imaging landmarks including the GPA, gingival margin (GM), and palatal masticatory mucosa (PMM). A 5-mm-thick solid hydrogel couplant was integrated to replace traditional ultrasound gel and avoid bubbles when moving the transducer. RESULTS A panorama image provided the relative localization of landmarks including the GPA, PMM, and hard palate. Short- and long-axis imaging of GPA was performed in five subjects including 3D mapping of GPA branches and surrounding tissues in a volume of 10 mm × 8 mm × 10 mm. Full-mouth Doppler imaging was also demonstrated on both the dorsal and ventral tongue as well as buccal mucosa and sublingual region on two subjects. CONCLUSIONS This study can measure the vertical distance from the GM to the GPA and depth from PMM to GPA and visualize the GPA localization in a 3D manner, which is critical to evaluate the available volume of palatal donor tissues and avoid sectioning of GPA during surgical harvesting of the tissues. Finally, the transducer's small size facilitates full-mouth Doppler imaging with the potential to improve the assessment, diagnosis, and management of oral mucosa.
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Affiliation(s)
- Baiyan Qi
- Materials Science and Engineering Program, University of California San Diego, La Jolla, California, United States
| | | | - Ali Hariri
- StyloSonic LLC, Lake Forest, California, United States
| | - Wonjun Yim
- Materials Science and Engineering Program, University of California San Diego, La Jolla, California, United States
| | - Zhicheng Jin
- Department of Nanoengineering, University of California San Diego, La Jolla, California, United States
| | - Lekshmi Sasi
- Department of Nanoengineering, University of California San Diego, La Jolla, California, United States
| | - Casey Chen
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, United States
| | - Jesse V Jokerst
- Materials Science and Engineering Program, University of California San Diego, La Jolla, California, United States
- Department of Nanoengineering, University of California San Diego, La Jolla, California, United States
- Department of Radiology, University of California San Diego, La Jolla, California, United States
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Konishi M, Kakimoto N. Radiomics analysis of intraoral ultrasound images for prediction of late cervical lymph node metastasis in patients with tongue cancer. Head Neck 2023; 45:2619-2626. [PMID: 37584449 DOI: 10.1002/hed.27487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/25/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND We investigated the predictability of late cervical lymph node metastasis using radiomics analysis of ultrasonographic images of tongue cancer. METHODS We selected 120 patients with tongue cancer who underwent intraoral ultrasonography, 30 of which had late cervical lymph node metastasis. Radiomics analysis was used to extract and quantify the image features. Bootstrap forest (BF), support vector machine (SVM), and neural tanh boost (NTB) were used as the machine learning models, and receiver operating characteristic curve analysis was conducted to determine diagnostic performance. RESULTS The sensitivity, specificity, accuracy, and AUC in the validation group were, respectively, 0.600, 0.967, 0.875, and 0.923 for the BF model; 0.700, 0.967, 0.900, and 0.950 for the SVM model; and 0.900, 0.967, 0.950, and 0.967 for NTB model. CONCLUSIONS Radiomics analysis and machine learning models using ultrasonographic images of pretreated tongue cancer could predict late cervical lymph node metastasis with high accuracy.
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Affiliation(s)
- Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Rodriguez Betancourt A, Samal A, Chan HL, Kripfgans OD. Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications. Z Med Phys 2023; 33:336-386. [PMID: 36922293 PMCID: PMC10517409 DOI: 10.1016/j.zemedi.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Ultrasound is a non-invasive, cross-sectional imaging technique emerging in dentistry. It is an adjunct tool for diagnosing pathologies in the oral cavity that overcomes some limitations of current methodologies, including direct clinical examination, 2D radiographs, and cone beam computerized tomography. Increasing demand for soft tissue imaging has led to continuous improvements on transducer miniaturization and spatial resolution. The aims of this study are (1) to create a comprehensive overview of the current literature of ultrasonic imaging relating to dentistry, and (2) to provide a view onto investigations with immediate, intermediate, and long-term impact in periodontology and implantology. METHODS A rapid literature review was performed using two broad searches conducted in the PubMed database, yielding 576 and 757 citations, respectively. A rating was established within a citation software (EndNote) using a 5-star classification. The broad search with 757 citations allowed for high sensitivity whereas the subsequent rating added specificity. RESULTS A critical review of the clinical applications of ultrasound in dentistry was provided with a focus on applications in periodontology and implantology. The role of ultrasound as a developing dental diagnostic tool was reviewed. Specific uses such as soft and hard tissue imaging, longitudinal monitoring, as well as anatomic and physiological evaluation were discussed. CONCLUSIONS Future efforts should be directed towards the transition of ultrasonography from a research tool to a clinical tool. Moreover, a dedicated effort is needed to introduce ultrasonic imaging to dental education and the dental community to ultimately improve the quality of patient care.
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Affiliation(s)
| | - Ankita Samal
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontology and Oral Medicine, Dental School, University of Michigan, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
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Prediction of nodal metastasis based on intraoral sonographic findings of the primary lesion in early-stage tongue cancer. Int J Oral Maxillofac Surg 2022; 52:515-523. [PMID: 36123273 DOI: 10.1016/j.ijom.2022.08.021] [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: 07/21/2020] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022]
Abstract
The aim of this study was to clarify the correlation between imaging findings obtained using intraoral ultrasonography (US) and pathological findings of tongue cancers, and to examine the predictive value of intraoral US findings with respect to occult nodal metastasis. This was a retrospective study based on the medical records of 123 patients with T1-2N0 tongue cancer. The depth of invasion (DOI) on intraoral US was positively correlated with the pathological invasion depth (PID) (ρ = 0.7080, P < 0.0001). Receiver operating characteristic analyses revealed an optimal DOI cut-off value of 4.1 mm and optimal PID cut-off value of 3.9 mm to detect nodal metastasis. Regarding the margin shape of the primary tumour on intraoral US, the incidence of nodal metastasis was significantly higher for the permeated type than for the pressure type (P < 0.001) and wedge-shaped type (P = 0.002). Furthermore, tumours with peritumoural vascularity assessed by power Doppler US had a significantly higher incidence of nodal metastasis than tumours without (P = 0.003). The sensitivity, specificity, and accuracy of the permeated type to predict nodal metastasis was 53.6%, 95.8%, and 86.2%, respectively. These results suggest that intraoral US findings closely reflect pathological findings and could be useful to predict occult nodal metastasis in patients with early-stage tongue cancer.
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Shibata M, Ishikawa A, Ishii J, Anzai E, Yagishita H, Izumo T, Sumino J, Katsurano M, Kim Y, Kanda H, Ushijima M, Yagihara K, Yoda T. Stiffness of tongue squamous cell carcinoma measured using strain elastography correlates with the amount of collagen fibers in the tumor. Oral Radiol 2022; 38:278-287. [PMID: 34302572 DOI: 10.1007/s11282-021-00556-0] [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: 03/03/2021] [Accepted: 07/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the stiffness of tongue squamous cell carcinoma (TSCC) using ultrasound strain elastography, a relatively new sonographic imaging technique, and to identify the factors that affect this stiffness. METHODS We treated 62 patients diagnosed with muscle invasive TSCC, who were treated at the department of oral surgery of our institution. Each patient's tumor stiffness was semi-quantified according to the ratio of cancer to tongue muscle strain measured using ultrasound strain elastography (the strain ratio). Histopathological diagnosis was made on the same section as the ultrasound strain elastography. We set the following histopathological parameters: cancer cell content in the tumor area (%CCC), collagen fiber content in the tumor area (%CFC), and tumor-infiltrating inflammatory cell content in the stromal compartment (%TIIC). Spearman's rank correlation (rs) was used to assess correlations, and P values < 0.05 were considered significant. RESULTS The mean strain ratio was 9.7 ± 9.8. The mean %CCC was 38.4 ± 11.3%, and % CFC was 31.1 ± 7.8%, % TIICs was 19.9 ± 8.9%. Log (strain ratio) by ultrasound strain elastography was positively correlated with %CFC (rs = 0.379, P = 0.024). %CFC was negatively correlated with %TIICs (rs = - 0.318, P = 0.012). No correlations were observed between other clinico-histopathological factors and either strain ratio, or %CFC. CONCLUSION The strain ratio of the cancer to the strain of the tongue muscle measured through ultrasound strain elastography positively correlates with the collagen fiber content of the tumor area.
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Affiliation(s)
- Mari Shibata
- Department of Oral Surgery, Saitama Cancer Center, Saitama, Japan.,Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Junichi Ishii
- Department of Oral Surgery, Saitama Cancer Center, Saitama, Japan
| | - Eri Anzai
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hisao Yagishita
- Department of Pathology, Saitama Cancer Center, Saitama, Japan
| | - Toshiyuki Izumo
- Department of Pathology, Saitama Cancer Center, Saitama, Japan
| | - Jun Sumino
- Department of Oral Surgery, Saitama Cancer Center, Saitama, Japan
| | - Miki Katsurano
- Department of Oral Surgery, Saitama Cancer Center, Saitama, Japan
| | - Yusoon Kim
- Department of Oral Surgery, Saitama Cancer Center, Saitama, Japan
| | - Hiroaki Kanda
- Department of Pathology, Saitama Cancer Center, Saitama, Japan
| | - Masaru Ushijima
- Clinical Research and Medical Development Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | | | - Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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[Sonography of the head and neck area - Part 1: Endosonography]. Laryngorhinootologie 2021; 100:483-498. [PMID: 34062579 DOI: 10.1055/a-1353-7859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sonography of the head and neck area plays a major role in both outpatient and inpatient ear, nose and throat medicine. Transcervical ultrasound is an important imaging method, especially in lymph node and tumor diagnostics. Its advantage is the ubiquitous availability and the excellent combinability with endoscopy and palpation. Despite decades of experience with sonography in the head and neck area, in contrast to the transcutaneous application, the transoral or endosonographic approach has so far not been widely used. Here it is often not due to the technical capabilities of the examiner, but rather to the unusual approach within the scope of the investigation. In this context, endosonography may be used primarily in tumor diagnostics in order to establish a complete sonographic examination from in- and outside.
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Konishi M, Sakamoto S, Ogawa I, Yoshioka Y, Ono S, Kakimoto N. Relationships between intraoral ultrasonographic and histopathological findings in patients with tongue cancer. Head Neck 2021; 43:2778-2785. [PMID: 34050571 DOI: 10.1002/hed.26763] [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: 03/15/2021] [Accepted: 05/14/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In this study, we aimed to investigate the relationships between histopathological and intraoral ultrasonographic (IUS) findings in patients with tongue cancer. METHODS IUS and histopathological findings in 46 patients with tongue cancer were considered for this study. We assessed the relationships between IUS findings regarding tumor thickness, margin type, border type, and internal echo intensity; internal/peripheral Doppler findings; and muscle invasion and histopathological findings regarding tumor thickness, differentiation, Yamamoto-Kohama (YK)-classification grade, blood vessel invasion, lymphatic invasion, perineural invasion, and muscle invasion. RESULTS Statistical associations were found between the following findings: between thickness determined through IUS measurement and that determined through histopathological measurement, between the IUS findings regarding tumor margin and border types and the histopathologically determined YK-classifications grades, and between a Doppler image of the internal area of tongue lesions and lymphatic invasion. CONCLUSIONS IUS findings may be used to predict histopathological findings about tumor thickness and YK-classification grades.
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Affiliation(s)
- Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Shinnichi Sakamoto
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Ikuko Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Yoshioka
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigehiro Ono
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Tsuka T, Okamoto Y, Sunden Y, Morita T, Yamashita M, Osaki T, Azuma K, Amaha T, Ito N, Murahata Y, Imagawa T. Ultrasonography of sudden swollen tongue in a calf. BMC Vet Res 2020; 16:200. [PMID: 32546145 PMCID: PMC7298850 DOI: 10.1186/s12917-020-02398-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In cattle, the lingual diseases are primarily diagnosed postmortem by histopathological examination of the affected tongues obtained after the death or during necropsy. In humans, ultrasonography has been used to provide differential diagnoses, and for preoperative or intraoperative planning of glossectomy in various lingual diseases. This is a bovine clinical case report, in which ultrasonography for sudden swelling of the tongue, which was possibly caused by snake bite, was utilized as a preoperative indication to perform a glossectomy. CASE PRESENTATION An eight-month-old female Japanese black calf presented with sudden swelling of the tongue with well-defined discoloration in the cranial region. A 10-MHz linear probe on a portable-type ultrasound machine (MyLabOne VET, Esaote Co., Genova, Italy) was applied to the ventral surface of the tongues in the affected case, and also in five healthy calves under sedation to observe normal tongues. Ultrasonography of the swollen tongue in this case revealed that the ventral lingual muscular layers were severely thickened compared with those of normal tongues. However, the muscle layers were regularly aligned with the echogenic muscular fibers. This resembled the lingual muscular architectures of normal tongues. Color-flow Doppler ultrasonography revealed that blood flow was weakened in the small peripheral vessels in the spaces between the lingual muscular structures, and was lacking in the deep lingual artery between the apex and base of the tongue. This finding was very different than that of normal tongues, which exhibited weakened or rich blood flows. Based on ultrasonographic findings, this case was treated with glossectomy. After recovery, the calf grew up normally with a normal appetite and rumination, and did not exhibit mouth pain behavior. Histopathologically, hemorrhagic necrotic changes, together with focal formation of fibrin thrombus in the lingual blood vessels in the affected tongue, were noted. CONCLUSIONS To the best of our knowledge, the present report is the first description of lingual ultrasonography performed in cattle. In this case, ultrasonography enabled visualization of decreased vascularity, which might be associated with hemorrhage or formation of fibrin thrombus in the suddenly swollen tongue presented.
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Affiliation(s)
- Takeshi Tsuka
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan.
| | - Yoshiharu Okamoto
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
| | - Yuji Sunden
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
| | - Takehito Morita
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
| | - Masamichi Yamashita
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
| | - Tomohiro Osaki
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
| | - Kazuo Azuma
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
| | - Takao Amaha
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
| | - Norihiko Ito
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
| | - Yusuke Murahata
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
| | - Tomohiro Imagawa
- Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101, Koyama-Minami, Tottori, Japan
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Izzetti R, Vitali S, Aringhieri G, Oranges T, Dini V, Nisi M, Graziani F, Gabriele M, Caramella D. Discovering a new anatomy: exploration of oral mucosa with ultra-high frequency ultrasound. Dentomaxillofac Radiol 2020; 49:20190318. [PMID: 32364758 DOI: 10.1259/dmfr.20190318] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Ultra-high frequency ultrasound (UHFUS) is a recently developed diagnostic technique involving the use of ultrasound frequencies up to 70 MHz, allowing to obtain 30 µm resolution of targets located within 1 cm from the surface. Oral mucosa can be affected by diverse pathological conditions, which are currently investigated by means of clinical examination. In this scenario, intraoral UHFUS can provide additional information and support clinical assessment of oral mucosa. In this preliminary study, typical features of normal oral mucosa are described, in order to set a benchmark for the future identification of oral soft tissue alterations. METHODS Twenty healthy subjects (10 males and 10 females, mean age 30 years) were enrolled and underwent intraoral UHFUS examination. In all the subjects, tongue, buccal mucosa, gingiva, lip mucosa, and palate were scanned, and images acquired. Intraoral UHFUS scan included Brightness-mode and Doppler mode acquisitions performed with a standardized protocol. UHFUS images were postprocessed and analyzed using a dedicated software. UHFUS-based biomarkers (epithelial thickness, echogenicity, and vascularization) were employed for image description. RESULTS Normal oral anatomy of the different sites analyzed was described. For all the sites, UHFUS biomarkers were characterized, and information on typical aspect of oral mucosa was retrieved. CONCLUSIONS In this explorative study, we suggest a potential role for intraoral UHFUS in the study of oral mucosa, giving insights into the possibility to improve the assessment, diagnosis, and management of the conditions involving oral mucosa. UHFUS seems a promising tool, which could potentially support clinical examination in daily oral medicine practice.
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Affiliation(s)
- Rossana Izzetti
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Saverio Vitali
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Teresa Oranges
- Unit of Dermatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valentina Dini
- Unit of Dermatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marco Nisi
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Filippo Graziani
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Mario Gabriele
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Davide Caramella
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Early tongue carcinomas (clinical stage I and II): echo-guided three-dimensional diode laser mini-invasive surgery with evaluation of histological prognostic parameters. A study of 85 cases with prolonged follow-up. Lasers Med Sci 2019; 35:751-758. [PMID: 31834561 DOI: 10.1007/s10103-019-02932-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 11/27/2019] [Indexed: 12/15/2022]
Abstract
The management of patients with early stage (cT1-T2) tongue squamous cell carcinoma without clinicoradiologic evidence of neck node metastasis (cN0) has been widely debated over the last 3 decades and still remains controversial. Nevertheless, the identification of patients with low-stage tumours at high-risk for occult cervical metastases is imperative before planning treatments of primary tumours, as well as that of prognostic markers which may possibly select those patients who may benefit of additional workup after surgery in view of the high metastatic potential of the primary tumour. The pre-surgical evaluation of tongue malignant primary tumour (for assessing lateral and deep margins) along with diode laser surgery (with accurate incision, bleeding-free and with reduced/absent post-surgical complications) may lead to a more conservative but equally decisive surgical treatment, also with a greater patient compliance. We studied 85 consecutive cases of cT1-T2 N0 tongue squamous cell carcinoma who had been managed by the following diagnostic/therapeutic protocol: pre-operative high definition ultrasound examination for the evaluation of size and depth, followed by three-dimensional surgical excision by diode laser (wavelength of 800 ± 10 nm, output power of 8 W in continuous wave, flexible optic fibre of 320 μm in contact mode) and detailed histological analyses of well-established prognostic parameters (tumour grade, thickness, depth, front of infiltration and surgical margins) with statistical analysis. No post-surgical photobiomodulation was performed. Overall, 58.82% of patients were stage I, 18% stage II, and the most frequent histotype was squamous cell carcinoma (97.64%). Large nests invasion pattern was observed in 64 cases, expansive pattern in 9, invasion in single cells in 12; front of invasion involved the muscle in 62 cases, vessels in 6, nerves in 15; peritumoural vascular invasion was assessed in 6 patients and perineural invasion in 15. Selective neck lymphadenectomy was performed in 9 cases, and clinically occult node metastases were detected in two cases. At follow-up, 78 patients (98.73%) were alive and free of disease, one patient experienced tumour-related death, while the remaining 6 died for non-disease-related causes. All the histological prognostic parameters were statistically significant (χ2 test; p = 0.05), thus leading to a prognostic weight classification with a three-tiered stratification. On the bases of these results, the authors maintain that the reported diagnostic/therapeutic protocol, including the pre-operative echo-guided three-dimensional evaluation, the following diode laser mini-invasive surgery for tumour excision and the histological examination along with the proposed three-tiered stratification of histological prognostic parameters may allow proper management of clinical stage I and II early tongue carcinomas.
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Ariji Y, Fukuda M, Kise Y, Nozawa M, Nagao T, Nakayama A, Sugita Y, Katumata A, Ariji E. A preliminary application of intraoral Doppler ultrasound images to deep learning techniques for predicting late cervical lymph node metastasis in early tongue cancers. ACTA ACUST UNITED AC 2019. [DOI: 10.1002/osi2.1039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Motoki Fukuda
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Yoshitaka Kise
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Michihito Nozawa
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Atsushi Nakayama
- Department of Oral and Maxillofacial Surgery Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Yoshihiko Sugita
- Department of Oral Pathology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Akitoshi Katumata
- Department of Oral Radiology Asahi University School of Dentistry Mizuho Japan
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
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14
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Joo YH, Cho JK, Koo BS, Kwon M, Kwon SK, Kwon SY, Kim MS, Kim JK, Kim H, Nam I, Roh JL, Park YM, Park IS, Park JJ, Shin SC, Ahn SH, Won S, Ryu CH, Yoon TM, Lee G, Lee DY, Lee MC, Lee JK, Lee JC, Lim JY, Chang JW, Jang JY, Chung MK, Jung YS, Cho JG, Choi YS, Choi JS, Lee GH, Chung PS. Guidelines for the Surgical Management of Oral Cancer: Korean Society of Thyroid-Head and Neck Surgery. Clin Exp Otorhinolaryngol 2019; 12:107-144. [PMID: 30703871 PMCID: PMC6453784 DOI: 10.21053/ceo.2018.01816] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/14/2018] [Indexed: 01/08/2023] Open
Abstract
Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient’s treatment goals.
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Affiliation(s)
- Young-Hoon Joo
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Keun Cho
- Department of Otorhinolaryngology Head and Neck Surgery, Inje University College of Medicine, Busan, Korea
| | - Bon Seok Koo
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Minsu Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Eulji University School of Medicine, Daejeon, Korea
| | - Seong Keun Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Soon Young Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Min-Su Kim
- Department of Otorhinolaryngology Head and Neck Surgery, CHA University School of Medicine, Seongnam, Korea
| | - Jeong Kyu Kim
- Department of Otorhinolaryngology Head and Neck Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Heejin Kim
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Innchul Nam
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otorhinolaryngology Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Min Park
- Department of Otorhinolaryngology Head and Neck Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Il-Seok Park
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Jung Je Park
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sung-Chan Shin
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Soon-Hyun Ahn
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seongjun Won
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Chang Hwan Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Tae Mi Yoon
- Department of Otorhinolaryngology Head and Neck Surgery, Chonnam National University Medical School, Hwasun, Korea
| | - Giljoon Lee
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Doh Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Myung-Chul Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Joon Kyoo Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Chonnam National University Medical School, Hwasun, Korea
| | - Jin Choon Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology Head and Neck Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Won Chang
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jeon Yeob Jang
- Department of Otorhinolaryngology Head and Neck Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yuh-Seok Jung
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Jae-Gu Cho
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Yoon Seok Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Yeungnam University College of Medicine, Daegu, Korea
| | - Jeong-Seok Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Inha University School of Medicine, Incheon, Korea
| | - Guk Haeng Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Phil-Sang Chung
- Department of Otorhinolaryngology Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
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