Evaluation of Tongue Cancer Using High-Resolution Sonography: Comparison With Magnetic Resonance Imaging

To evaluate the role of sonography in assessing tongue cancer compared with magnetic resonance imaging (MRI).

A randomized prospective study was performed on 40 cases of tongue cancer. Magnetic resonance imaging and sonography of the tongue were performed, tumor spreading to particular sites was recorded in all cases. Sonographic and MRI findings were correlated with histopathologic findings in 18 operable cases. In 22 inoperable cases, sonography was compared only with MRI.

In operable patients, sonography achieved sensitivity of 61.1%, whereas MRI achieved sensitivity of 94.4%. The difference was statistically significant (P < .05). The results for detection of individual site involvement on sonography and MRI were as follows: intrinsic muscles only, 0 and 6, respectively; tongue base, 5 and 5; genioglossus muscle, 34 and 34; mylohyoid muscle, 9 and 8; sublingual space, 12 and 14; sublingual neurovascular bundle, 12 and 12; submandibular gland, 3 and 3; spread across the lingual septum, 17 and 17; and alveolar involvement, 0 and 1. There was no significant difference (P> .05) between sonography and MRI in detecting involvement of the above-mentioned sites except for cases with only intrinsic muscles and alveolar involvement. Tumors involving intrinsic tongue muscles only were not visualized on sonography. They all underwent surgery, resulting in reduced sensitivity of sonography in operable cases.

Even though small tumors were difficult to visualize, sonography can play an important role in assessment of tumor extension in large growths, especially when MRI is unavailable, contraindicated, or unaffordable, and for posttreatment follow-up.