title: Vascularity as assessed by Doppler intraoral ultrasound around the invasion front of tongue cancer is a predictor of pathological grade of malignancy and cervical lymph node metastasis.
abstract: OBJECTIVE
  To quantitatively evaluate the relationship of vascularity of tongue cancer as demonstrated on intraoral ultrasonography images and tumour thickness with pathological grade of malignancy and the presence of cervical lymph node metastases.
  
  
  METHODS
  18 patients with tongue cancer were enrolled in this retrospective study. Using Doppler ultrasonography images of the invasion front of the cancers along the length of their tumour boundaries, three vascular indexes were analysed quantitatively, namely ratio of blood flow signal area within the cancer to whole tumour area (BAR), blood flow signal number ratio (BNR) and blood flow signal width ratio (BWR). The associations between these three indexes and occurrence of cervical lymph node metastasis and pathological grade of malignancy [Yamamoto-Kohama (YK) classification] were assessed. Furthermore, the relationship between tumour thickness and occurrence of cervical lymph node metastasis was evaluated on B-mode intraoral ultrasonography images.
  
  
  RESULTS
  There was no significant association between BAR and tumour thickness or occurrence of cervical lymph node metastasis. The BNRs and BWRs of patients with cervical lymph node metastasis were significantly higher than those of patients without nodal involvement. The BWRs of patients with high-grade malignancy (YK-4C) were significantly higher than those of patients with low-grade malignancy (YK-2 or 3).
  
  
  CONCLUSIONS
  BNR and BWR on the invasion front of the tongue cancer are predictors of pathological grade of malignancy and cervical lymph node metastasis.
authors.affiliation: 1 Section of Image Diagnostics, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Yamamoto
authors.affiliation: 1 Section of Image Diagnostics, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yuasa
authors.affiliation: 2 Department of Morphological Biology, Fukuoka Dental College, Fukuoka, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Okamura
authors.affiliation: 1 Section of Image Diagnostics, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Shiraishi
authors.affiliation: 1 Section of Image Diagnostics, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Miwa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000556:secondary; D018289:Carcinoma, Verrucous / Q000098:blood supply / Q000000981:diagnostic imaging / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D012372:ROC Curve; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D014062:Tongue Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler / Q000379:methods*
keywords: Doppler ultrasonography; metastasis; tongue cancer