Assessing the Potential of Ultrasound Elastography in Diagnosing Early Oral Cancers

Early diagnosis of oral cancer is critical for improving treatment outcomes and survival rates. Conventional diagnostic techniques often fail to detect early-stage lesions due to their subtle clinical presentation. Ultrasound elastography (USE), a non-invasive imaging modality, offers potential as a diagnostic tool by evaluating the stiffness of tissues, which is a characteristic feature of malignant transformations. This study aims to assess the efficacy of USE in diagnosing early oral cancers.

A prospective study was conducted on 50 patients presenting with suspicious oral lesions. USE was performed using a high-frequency linear transducer. The stiffness of the lesions was quantified using strain ratios and Young's modulus values. Histopathological evaluation of biopsy specimens was used as the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of USE were calculated. Arbitrary values were assigned to test diagnostic accuracy.

Of the 50 lesions examined, 35 were confirmed as malignant and 15 as benign through histopathology. USE identified malignant lesions with a sensitivity of 91.4% and specificity of 86.7%. The average stiffness values (Young's modulus) for malignant lesions were significantly higher (23.5 ± 4.3 kPa) compared to benign lesions (8.2 ± 2.1 kPa; P < 0.001). The strain ratio was similarly elevated in malignant lesions (mean: 4.8) compared to benign lesions (mean: 1.9). PPV and NPV were 94.6% and 81.3%, respectively, indicating high diagnostic accuracy.

Ultrasound elastography is a promising non-invasive diagnostic tool for early detection of oral cancers. Its ability to differentiate malignant from benign lesions based on tissue stiffness can enhance clinical decision-making. Future large-scale studies are warranted to validate these findings and establish standardized protocols for its clinical application.