PREOPERATIVE INTRA-ORAL ULTRASOUND IN THE EVALUATION OF EARLY ORAL SQUAMOUS CELL-CARCINOMA: PROSPECTIVE STUDY

Preoperative evaluation of depth of invasion can predict occult metastasis in cervical lymph nodes of OSCC patients and target patients who need neck dissection but there is no standard modality to determine this parameter preoperatively. The primary aim of this study was to evaluate the accuracy of a preoperative measurement of depth of invasion using Ultrasonography and correlate the values obtained with histologically determined DOI measurements. Specifically, we used a very small and thin Ultrasound probe, like a toothbrush, that help directly reach the oral lesions. We enrolled 32 biopsy proven primary T1/T2/T3 OSCC patients who underwent pre-operative intraoral ultrasound for the evaluation of the tumor diameter and depth of invasion. Ultrasound sensitivity, specificity and accuracy in the assessment of the infiltration of the lamina propria, the correlation between Ultrasound and histological depth of invasion and the correlation between diameter of the lesion and depth of invasion assessed with Ultrasound were evaluated. Ultrasound sensitivity and specificity in the assessment of the infiltration of the lamina propria were respectively 93.3% and 100%. A significant correlation was found between the measurement of US-obtained and histologically obtained depth of invasion (r = 0.907; p < .0001; 95% CI, 0.816 to 0.954). A medium correlation was found between diameter of the lesion and depth of invasion assessed with Ultrasound (r = 0.591; p < .0001; 95% CI, 0.306 to 0.779). According to our results, intraoral Ultrasound is very accurate in determining tumor depth of invasion in OSCC patients and represents a useful, cost-effective and promisig tool to insert in the diagnostic flow-chart of OSCC.