TY - JOUR
T1 - OFFICE-BASED TRANSORAL AND TRANSCERVICAL ULTRASOUND FOR DETECTING AND STAGING OROPHARYNGEAL CANCERS
AU - Garset-zamani, Martin
AU - Kjærgaard, Thomas
AU - Hvilsom, Gitte
AU - O’Leary, Padraig
AU - Wennerwaldt, Kasper
AU - Bøgh, Mads
AU - Hahn, Christoffer Holst
AU - Kaltoft, Mikkel
AU - Plaschke, Christina Caroline
AU - Mikkelsen, Ronni
AU - Norling, Rikke
AU - Dejanovic, Danijela
AU - Hall, Johanna Maria
AU - Agander, Tina Klitmøller
AU - Wessel, Irene
AU - Ersbøll, Annette Kjær
AU - Buchwald, Christian von
AU - Todsen, Tobias
N1 - The 20th Congress of World Federation for Ultrasound in Medicine and Biology
PY - 2025
Y1 - 2025
N2 - Introduction Distinction between asymmetric palatine tonsils and oropharyngeal squamous cell carcinoma (OPSCC) is difficult with current clinical and radiographic work-up. Furthermore, human papillomavirus (HPV) induced OPSCC can present with nodal metastasis and undetected small primary cancers i.e. as unknown primary (CUP). Ultrasound (US) of the oropharynx may improve the outpatient work-up of these patients. We aimed to compare the diagnostic accuracy for oropharyngeal tumor detection using US and magnetic resonance imaging (MRI). Secondly, to compare tumor staging between these modalities. Methods This was a multicenter, prospective, clinical trial with paired comparison between US and MRI. Patients with suspected OPSCC or neck lumps were assessed clinically by head and neck surgeons. If an oropharyngeal tumor or neck metastasis was suspected, patients were offered inclusion. Exclusion criteria were prior history of head and neck cancer, MRI, or positron emission tomography/computed tomography (PET/CT) within three months, and prior oropharyngeal biopsy results. After clinical exam, surgeon-performed transoral and transcervical US of the oropharynx was performed prior to biopsy results and cross-sectional imaging. MRIs were performed afterwards (including PET/CTs if suspected metastasis from CUP) and these were assessed blinded to US and histopathology. The primary outcome was the sensitivity and specificity for oropharyngeal tumor detection with transoral- and transcervical US and MRI. Secondly, we compared T-staging between US, MRI, and CT. Results We included 162 patients with available MRI, transoral US, and transcervical US (105 [65 %] male; median age 63 years [IQR, 55-71 years]); 65 (82 %) of 80 HPV-tested OPSCCs were HPV-positive). A full transoral US exam could be completed in 78% of cases. Compared to MRI, transoral US had similar sensitivity (86% vs. 92%, P = .11) but significantly higher specificity (79% vs. 46%, P
AB - Introduction Distinction between asymmetric palatine tonsils and oropharyngeal squamous cell carcinoma (OPSCC) is difficult with current clinical and radiographic work-up. Furthermore, human papillomavirus (HPV) induced OPSCC can present with nodal metastasis and undetected small primary cancers i.e. as unknown primary (CUP). Ultrasound (US) of the oropharynx may improve the outpatient work-up of these patients. We aimed to compare the diagnostic accuracy for oropharyngeal tumor detection using US and magnetic resonance imaging (MRI). Secondly, to compare tumor staging between these modalities. Methods This was a multicenter, prospective, clinical trial with paired comparison between US and MRI. Patients with suspected OPSCC or neck lumps were assessed clinically by head and neck surgeons. If an oropharyngeal tumor or neck metastasis was suspected, patients were offered inclusion. Exclusion criteria were prior history of head and neck cancer, MRI, or positron emission tomography/computed tomography (PET/CT) within three months, and prior oropharyngeal biopsy results. After clinical exam, surgeon-performed transoral and transcervical US of the oropharynx was performed prior to biopsy results and cross-sectional imaging. MRIs were performed afterwards (including PET/CTs if suspected metastasis from CUP) and these were assessed blinded to US and histopathology. The primary outcome was the sensitivity and specificity for oropharyngeal tumor detection with transoral- and transcervical US and MRI. Secondly, we compared T-staging between US, MRI, and CT. Results We included 162 patients with available MRI, transoral US, and transcervical US (105 [65 %] male; median age 63 years [IQR, 55-71 years]); 65 (82 %) of 80 HPV-tested OPSCCs were HPV-positive). A full transoral US exam could be completed in 78% of cases. Compared to MRI, transoral US had similar sensitivity (86% vs. 92%, P = .11) but significantly higher specificity (79% vs. 46%, P
U2 - 10.1016/j.ultrasmedbio.2025.10.209
DO - 10.1016/j.ultrasmedbio.2025.10.209
M3 - Journal article
SN - 0301-5629
VL - 51
SP - S64
JO - Ultrasound in Medicine & Biology
JF - Ultrasound in Medicine & Biology
ER -