The Vascularisation of Oral Cavity Tumours and Tumour Shell Tissue Determined by Three-Dimensional Power Doppler Sonography

Abstract 

The aim of the study was to determine and quantify the vascularity of oral cavity tumours and peritumoural tissue by using 3-D power Doppler sonography (3-D PDS) and to compare the vascularity of metastatic and nonmetastatic tumours. The investigation was carried out preoperatively on 49 patients with squamous carcinoma of the tongue and floor of the mouth. Collected data were analysed with the help of virtual program of computer-aided analysis (VOCAL)-imaging program by which the borders of a structure could be defined and vascularity quantified by analysing 3D colour histograms. Vascularity was defined by three indices, VI- vascularisation index, FI- flow index and VFI- vascularisation-flow index. The vascularity of oral cavity tumours was determined in 4 mm and 7 mm shells surrounding the tumour. Modified neck dissection was performed in all of the patients and lymph nodes were examined histologically. Peritumorous tissue vascularity was significantly higher in metastatic (N+ neck) than it was in nonmetastatic (N0 neck) tumours. Indices VI and VFI in 4 mm and 7 mm shells differed significantly between N+ and N0 tumours (p < 0.01). Flow index (FI) did not show any difference between N0 and N+ necks. The difference between vascularity indices VI and VFI of peritumorous tissue and tumour was also varied significantly between N0 and N+ neck (p < 0.05) and was higher in N+ tumours. With VOCAL software and 3-D power Doppler sonography, the vascularity of peritumorous tissue could be quantified successfully. Tumours which had metastasised showed richer vascularity in their shells and a greater difference in vascularity between the shell and tumour tissue. (E-mail: janez.rebol@guest.arnes.si)

Key Words: 3-D power Doppler, 3-D sonography, oral cavity tumours, vascularity, VOCAL, neck metastases