Color Doppler ultrasonography in oral squamous cell carcinoma: Making ultrasonography more meaningful

Abstract

Background: Although color Doppler ultrasonography (CD-USG) is useful in the diagnosis of various diseases of the head and neck, flow signals in the malignant oral tumors are less studied; hence, the present study was designed to study the usefulness of CD-USG in quantifying oral squamous cell carcinoma (OSCC) vascularization and in determining the hemodynamic parameters by spectral analysis obtained during CD-USG procedure. Aims: To study the usefulness of CD-USG in mapping OSCC of buccal mucosa, tongue, and lip. Materials and Methods: This was a case-control study, conducted among 60 subjects aged 20-70 years. Group A consisted of 30 cases of OSCC of buccal mucosa, tongue, and lip while Group B consisted of 30 controls. CD-USG investigation of each mass was carried out. The spectral waveform (time-velocity Doppler spectrum) of flow signal was analyzed for the pulsatility index, resistivity index (RI), peak systolic velocity (PSV) (m/s), and end diastolic velocity (EDV) (m/s). All patients had real-time, gray-scale sonography and CD-USG with spectral wave analysis. Results: In this study, the mean value for RI in patients with malignancy was 0.40 ± 0.14 whereas for healthy subjects, it was 0.83 ± 0.07. Mean value for PI in patients with malignancy was 0.86 ± 0.20 whereas for healthy subjects, it was 2.61 ± 0.77. In the present study, the mean PSV in malignant masses was 31.72 ± 13.48 whereas for healthy subjects, it was 43.87 ± 20.95, and the EDV in malignant masses was 10.33 ± 5.21 whereas for healthy subjects, it was 7.07 ± 3.44. Conclusion: The said Doppler indices were shown to be sensitive as well as specific for the diagnosis of malignant oral tumors. Although CD-USG cannot replace histopathological procedures, it plays a definite role as an adjunct to the clinical evaluation of OSCC cases.