Evaluating oropharyngeal carcinoma with transcervical ultrasound, CT, and MRI

Farhoud Faraji, Stephanie Coquia, Meghan B. Wenderoth, Ericka S. Padilla, Dana Blitz, M. Robert DeJong, Nafi Aygun, Ulrike Maria Hamper, Carole Fakhry

Research output: Contribution to journalArticle

Abstract

Objective: To compare transcervical ultrasonography (US) to standard cross-sectional imaging for the visualization of human papillomavirus-related oropharyngeal cancer (HPV-OPC). Materials and methods: Patients with HPV-OPC and available standard imaging (CT and/or MRI) were identified in clinic and prospectively enrolled. US was performed to visualize the oropharynx and lymph nodes. Tumor characteristics across imaging modalities were evaluated (CT versus MRI, and US versus standard imaging (SI)). Results: Forty-three patients were included. The overall blinded detection rates for CT and MRI were 83% and 71%, respectively. The unblinded detection rate for US was 98%. Agreement of tumor anatomic subsite was moderate for both CT vs MRI (κ = 0.59) and US vs SI (κ = 0.47). Comparison of tumor size by CT and MRI showed statistically significant correlations in craniocaudal (CC), anteroposterior (AP), and mediolateral (ML) dimensions (RhoCC = 0.51, pCC = 0.038; RhoAP = 0.81, pAP < 0.0001; RhoML = 0.57, pML = 0.012). Tumor size estimates by US and SI showed statistically significant correlations in CC and AP, but not ML (RhoCC = 0.60, pCC = 0.003; RhoAP = 0.71, pAP < 0.0001; RhoML = 0.30, pML = 0.08). Tumor volume estimates improved correlations between US and SI (Rho = 0.66, p < 0.0001). Stratification of US patients into early and late imaging studies demonstrated an increase in correlation strength from early (Rho = 0.32, p = 0.32) to late groups (Rho = 0.77, p < 0.0001) demonstrating that ultrasound accuracy improved with experience. Conclusions: Our findings suggest that transcervical ultrasonography is a sensitive and relatively accurate adjunct to standard imaging for the evaluation of oropharyngeal tumors. Its cost, portability, and potential for in-clinic and serial imaging render US an attractive modality to further develop for imaging oropharyngeal tumors.

Original languageEnglish (US)
Pages (from-to)177-185
Number of pages9
JournalOral Oncology
Volume78
DOIs
StatePublished - Mar 1 2018

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Ultrasonography
Carcinoma
Oropharyngeal Neoplasms
Neoplasms
Oropharynx
Tumor Burden
Lymph Nodes
Costs and Cost Analysis

Keywords

  • Computed tomography
  • Head and neck
  • Magnetic resonance imaging
  • Oropharynx
  • Squamous cell carcinoma
  • Ultrasound

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

Cite this

Evaluating oropharyngeal carcinoma with transcervical ultrasound, CT, and MRI. / Faraji, Farhoud; Coquia, Stephanie; Wenderoth, Meghan B.; Padilla, Ericka S.; Blitz, Dana; DeJong, M. Robert; Aygun, Nafi; Hamper, Ulrike Maria; Fakhry, Carole.

In: Oral Oncology, Vol. 78, 01.03.2018, p. 177-185.

Research output: Contribution to journalArticle

Faraji, Farhoud ; Coquia, Stephanie ; Wenderoth, Meghan B. ; Padilla, Ericka S. ; Blitz, Dana ; DeJong, M. Robert ; Aygun, Nafi ; Hamper, Ulrike Maria ; Fakhry, Carole. / Evaluating oropharyngeal carcinoma with transcervical ultrasound, CT, and MRI. In: Oral Oncology. 2018 ; Vol. 78. pp. 177-185.
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abstract = "Objective: To compare transcervical ultrasonography (US) to standard cross-sectional imaging for the visualization of human papillomavirus-related oropharyngeal cancer (HPV-OPC). Materials and methods: Patients with HPV-OPC and available standard imaging (CT and/or MRI) were identified in clinic and prospectively enrolled. US was performed to visualize the oropharynx and lymph nodes. Tumor characteristics across imaging modalities were evaluated (CT versus MRI, and US versus standard imaging (SI)). Results: Forty-three patients were included. The overall blinded detection rates for CT and MRI were 83{\%} and 71{\%}, respectively. The unblinded detection rate for US was 98{\%}. Agreement of tumor anatomic subsite was moderate for both CT vs MRI (κ = 0.59) and US vs SI (κ = 0.47). Comparison of tumor size by CT and MRI showed statistically significant correlations in craniocaudal (CC), anteroposterior (AP), and mediolateral (ML) dimensions (RhoCC = 0.51, pCC = 0.038; RhoAP = 0.81, pAP < 0.0001; RhoML = 0.57, pML = 0.012). Tumor size estimates by US and SI showed statistically significant correlations in CC and AP, but not ML (RhoCC = 0.60, pCC = 0.003; RhoAP = 0.71, pAP < 0.0001; RhoML = 0.30, pML = 0.08). Tumor volume estimates improved correlations between US and SI (Rho = 0.66, p < 0.0001). Stratification of US patients into early and late imaging studies demonstrated an increase in correlation strength from early (Rho = 0.32, p = 0.32) to late groups (Rho = 0.77, p < 0.0001) demonstrating that ultrasound accuracy improved with experience. Conclusions: Our findings suggest that transcervical ultrasonography is a sensitive and relatively accurate adjunct to standard imaging for the evaluation of oropharyngeal tumors. Its cost, portability, and potential for in-clinic and serial imaging render US an attractive modality to further develop for imaging oropharyngeal tumors.",
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AU - Coquia, Stephanie

AU - Wenderoth, Meghan B.

AU - Padilla, Ericka S.

AU - Blitz, Dana

AU - DeJong, M. Robert

AU - Aygun, Nafi

AU - Hamper, Ulrike Maria

AU - Fakhry, Carole

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N2 - Objective: To compare transcervical ultrasonography (US) to standard cross-sectional imaging for the visualization of human papillomavirus-related oropharyngeal cancer (HPV-OPC). Materials and methods: Patients with HPV-OPC and available standard imaging (CT and/or MRI) were identified in clinic and prospectively enrolled. US was performed to visualize the oropharynx and lymph nodes. Tumor characteristics across imaging modalities were evaluated (CT versus MRI, and US versus standard imaging (SI)). Results: Forty-three patients were included. The overall blinded detection rates for CT and MRI were 83% and 71%, respectively. The unblinded detection rate for US was 98%. Agreement of tumor anatomic subsite was moderate for both CT vs MRI (κ = 0.59) and US vs SI (κ = 0.47). Comparison of tumor size by CT and MRI showed statistically significant correlations in craniocaudal (CC), anteroposterior (AP), and mediolateral (ML) dimensions (RhoCC = 0.51, pCC = 0.038; RhoAP = 0.81, pAP < 0.0001; RhoML = 0.57, pML = 0.012). Tumor size estimates by US and SI showed statistically significant correlations in CC and AP, but not ML (RhoCC = 0.60, pCC = 0.003; RhoAP = 0.71, pAP < 0.0001; RhoML = 0.30, pML = 0.08). Tumor volume estimates improved correlations between US and SI (Rho = 0.66, p < 0.0001). Stratification of US patients into early and late imaging studies demonstrated an increase in correlation strength from early (Rho = 0.32, p = 0.32) to late groups (Rho = 0.77, p < 0.0001) demonstrating that ultrasound accuracy improved with experience. Conclusions: Our findings suggest that transcervical ultrasonography is a sensitive and relatively accurate adjunct to standard imaging for the evaluation of oropharyngeal tumors. Its cost, portability, and potential for in-clinic and serial imaging render US an attractive modality to further develop for imaging oropharyngeal tumors.

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