Magnetic resonance imaging (MRI) is the preferred imaging modality for oropharyngeal cancers (OPCs), but it has difficulties distinguishing between small OPCs and unilateral tonsil hypertrophy. We hypothesized that surgeon-performed transoral ultrasound (US) could be used to accurately detect T-stage OPCs. We performed a single-center prospective diagnostic accuracy study including patients with suspected or biopsy-verified OPCs during outpatient appointments. All patients were offered transoral US and MRI. If transoral US could not be tolerated by the patient, transcervical US was performed. The primary outcome was the diagnostic accuracy of detecting OPCs with US compared to MRI, using histopathology as the reference standard. The secondary outcome was comparing the primary tumor diameters between US and MRI blinded to each other. Out of the 26 patients included in the study, 21 (81%) had OPCs. Transoral US could be performed in 21/21 and 1/5 patients with suspected palatine and lingual tonsil OPCs, respectively. Overall, US diagnostic accuracy was 92%, compared to 81% with MRI (p= 0.37). US and MRI had a high correlation between tumor diameters in the anteroposterior diameter (R = 0.80,p< 0.001), corresponding to the depth axis on US. In conclusion, this small study showed the promise and feasibility of transoral US to improve the initial clinical evaluations of patients with suspected OPCs.
磁共振成像（MRI）是口咽癌（OPCs）的首选影像学检查方法，但难以区分小型口咽癌与单侧扁桃体肥大。我们假设外科医生实施的口腔内超声（US）可用于准确检测T分期口咽癌。我们开展了一项单中心前瞻性诊断准确性研究，纳入门诊中疑似或经活检确诊的口咽癌患者。所有患者均接受口腔内超声和磁共振成像检查。若患者无法耐受口腔内超声，则改为经颈部超声检查。主要结局是以组织病理学为金标准，比较超声与磁共振成像对口咽癌的诊断准确性。次要结局是比较超声与磁共振成像（互盲状态下）测量的原发肿瘤直径。研究纳入的26例患者中，21例（81%）确诊为口咽癌。21例疑似腭扁桃体口咽癌患者均成功实施口腔内超声，5例疑似舌扁桃体口咽癌患者中1例成功实施。总体而言，超声诊断准确率为92%，磁共振成像为81%（p=0.37）。在前后径（对应超声深度轴）测量中，超声与磁共振成像的肿瘤直径具有高度相关性（R=0.80，p<0.001）。本小型研究表明，口腔内超声在改善疑似口咽癌患者初始临床评估方面具有应用前景和可行性。
肿瘤(癌症)患者之家