Color Doppler Ultrasonography in Mapping Oral Squamous Cell Carcinoma

Background: Although Color Doppler Ultrasonography (CDUS) is useful in the diagnosis of various diseases of the head and neck, flow signals in oral malignant masses are less studied; hence the present study assesses the usefulness of Color Doppler Ultrasonography in quantifying oral squamous cell carcinoma (OSCC) vascularization. In addition, we determine the hemodynamic parameters by spectral analysis obtained during a Color Doppler Ultrasonography procedure. We have studied the usefulness of Color Doppler Ultrasonography in mapping oral squamous cell carcinoma of the buccal mucosa, tongue and lip. Methods: This case-control study enrolled 60 subjects aged 20-70 years. Group A constituted 30 cases diagnosed with oral squamous cell carcinoma and Group B constituted 30 healthy controls. Ultrasonographic investigation of each mass was performed. The spectral waveform (time-velocity Doppler spectrum) of the flow signal was analyzed for the pulsatility index, resistive index, peak systolic velocity (m/sec), and end diastolic velocity (m/sec). All patients had real-time, gray-scale sonography and Color Doppler Ultrasonography with spectral wave analysis. Results: The mean value for the resistive index in patients with oral squamous cell carcinoma was 0.40±0.14 whereas for healthy subjects, it was 0.83±0.07. The mean pulsatility index value in malignant patients was 0.86±0.20 while for healthy subjects, it came-out to be 2.61±0.77. Conclusion: These Doppler indices have been shown to be sensitive and specific for the diagnosis of malignant oral tumors. Although Color Doppler Ultrasonography cannot replace histopathological procedures, it plays a definite role as an adjunct to clinical evaluation of oral squamous cell carcinoma patients.