{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:02:00Z","timestamp":1784955720285,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"abstract":"ABSTRACT<\/jats:title>\n \n Purpose<\/jats:title>\n The prognostic significance of pathological depth of invasion (p\u2010DOI) is widely acknowledged, leading to its inclusion in the clinical and pathological staging systems for Oral Squamous Cell Carcinoma (OSCC) in the 8th Edition of the AJCC Cancer Staging Manual. However, radiologic assessment of DOI (r\u2010DOI) remains challenging, and limited evidence exists regarding its correlation with p\u2010DOI, the current gold standard. This study aims to evaluate the correlation between r\u2010DOI and p\u2010DOI in a large, real\u2010world cohort.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n Following Institutional Review Board approval, we evaluated 261 patients with biopsy\u2010proven OSCC who underwent primary surgery between 2010 and 2015. Radiological images were reviewed by a single subspecialty\u2010trained neuroradiologist, blinded to clinicopathological information. Preoperative MRI, CT, and FDG\u2010PET scans were analyzed; in cases of multiple imaging studies, the imaging modality that best depicted the tumor's invasive front in each individual case was selected for r\u2010DOI measurement. r\u2010DOI was calculated by measuring tumor depth from a horizontal reference line connecting the tumor to the adjacent normal mucosa. The correlation between r\u2010DOI and p\u2010DOI was assessed using Pearson's product\u2013moment correlation and visualized via scatterplot analysis. Outliers were defined as cases with residuals \u2265\u20092 standard deviations from the regression line.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The median age at diagnosis was 61.8\u2009years (59% male). The most common subsite was the oral tongue (55.9%), followed by the floor of mouth (11.5%), lower gum (14.9%), and other sites (combined 17.6%). Imaging modalities used for r\u2010DOI determination included CT (\n n<\/jats:italic>\n \u2009=\u2009187, 71.6%), PET\/CT (\n n<\/jats:italic>\n \u2009=\u200950, 19.2%), and MRI (\n n<\/jats:italic>\n \u2009=\u200924, 9.2%); 105 patients (40.2%) underwent both PET\/CT and CT, 11 (4.2%) had MRI and CT, 12 (4.6%) had PET\/CT and MRI, and 5 (1.9%) received all three modalities. The Pearson correlation coefficient between r\u2010DOI and p\u2010DOI, calculated as continuous variables, demonstrated a strong positive correlation (Pearson's\n r<\/jats:italic>\n \u2009=\u20090.834,\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our study demonstrates that routinely used standard\u2010of\u2010care imaging studies may provide a clinically useful adjunct for preoperative estimation of depth of invasion, with reduced reliability in intermediate\u2010depth (5\u201310\u2009mm) lesions, where cautious interpretation is warranted.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/hed.70370","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T04:29:32Z","timestamp":1784953772000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Correlation Between Radiologic and Pathological Depth of Invasion in Oral Squamous Cell Carcinoma: A Cohort of 261 Patients"],"prefix":"10.1002","author":[{"given":"Onur","family":"Yildirim","sequence":"first","affiliation":[{"name":"Department of Radiology Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9490-3619","authenticated-orcid":false,"given":"Danielli","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Department of Surgery, Head and Neck Service Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Valero","sequence":"additional","affiliation":[{"name":"Department of Surgery, Head and Neck Service Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alana","family":"Eagan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Head and Neck Service Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4638-9835","authenticated-orcid":false,"given":"Bin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pathology Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Ghossein","sequence":"additional","affiliation":[{"name":"Department of Pathology Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7636-5426","authenticated-orcid":false,"given":"Ian","family":"Ganly","sequence":"additional","affiliation":[{"name":"Department of Surgery, Head and Neck Service Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-5132","authenticated-orcid":false,"given":"Snehal G.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Surgery, Head and Neck Service Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilda E.","family":"Stambuk","sequence":"additional","affiliation":[{"name":"Department of Radiology Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","first-page":"122","article-title":"Head and Neck Cancers, Major Changes in the American Joint Committee on Cancer Eighth Edition Cancer Staging Manual","volume":"67","author":"Lydiatt W. M.","year":"2017","journal-title":"CA: A Cancer Journal for Clinicians"},{"issue":"6","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s11912-019-0799-x","article-title":"Changes in the 8th Edition of the American Joint Committee on Cancer (AJCC) Staging of Head and Neck Cancer: Rationale and Implications","volume":"21","author":"Zanoni D. K.","year":"2019","journal-title":"Current Oncology Reports"},{"issue":"4","key":"e_1_2_11_4_1","first-page":"242","article-title":"TNM Staging of Cancers of the Head and Neck: Striving for Uniformity Among Diversity","volume":"55","author":"Patel S. G.","year":"2005","journal-title":"CA: A Cancer Journal for Clinicians"},{"issue":"1","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.oooo.2020.07.003","article-title":"Preoperative Evaluation of Tumor Depth of Invasion in Oral Squamous Cell Carcinoma With Intraoral Ultrasonography: A Retrospective Study","volume":"131","author":"Rocchetti F.","year":"2021","journal-title":"Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology"},{"key":"e_1_2_11_6_1","first-page":"371","article-title":"Magnetic Resonance vs. Intraoral Ultrasonography in the Preoperative Assessment of Oral Squamous Cell Carcinoma: A Systematic Review and Meta\u2010Analysis","volume":"10","author":"Marchi F.","year":"2020","journal-title":"Frontiers in Oncology"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.oraloncology.2020.104749","article-title":"A Critical Evaluation of Computed Tomography\u2010Derived Depth of Invasion in the Preoperative Assessment of Oral Cancer Staging","volume":"107","author":"Locatello L. G.","year":"2020","journal-title":"Oral Oncology"},{"issue":"1","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/s00330-021-08148-6","article-title":"Assessment of Tumor Depth in Oral Tongue Squamous Cell Carcinoma With Multiparametric MRI: Correlation With Pathology","volume":"32","author":"Tang W.","year":"2022","journal-title":"European Radiology"},{"issue":"4","key":"e_1_2_11_9_1","first-page":"442","article-title":"The Accuracy of Magnetic Resonance Imaging to Measure the Depth of Invasion in Oral Tongue Cancer: A Systematic Review and Meta\u2010Analysis","volume":"51","author":"Li M.","year":"2022","journal-title":"International Journal of Oral and Maxillofacial Surgery"},{"issue":"10","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.oraloncology.2009.03.009","article-title":"Tumor Thickness, Depth of Invasion, and BCL\u20102 Expression Are Correlated With FDG\u2010Uptake in Oral Squamous Cell Carcinomas","volume":"45","author":"Suzuki H.","year":"2009","journal-title":"Oral Oncology"},{"issue":"1","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1002\/lary.30791","article-title":"Depth of Invasion in Carcinoma Tongue: Evaluation of Clinical and Imaging Techniques","volume":"134","author":"Kumar R.","year":"2024","journal-title":"Laryngoscope"},{"issue":"6","key":"e_1_2_11_12_1","first-page":"20220078","article-title":"Accuracy of MRI, CT, and Ultrasound Imaging on Thickness and Depth of Oral Primary Carcinomas Invasion: A Systematic Review","volume":"51","author":"Scotti F.","year":"2022","journal-title":"Dento Maxillo Facial Radiology"},{"key":"e_1_2_11_13_1","article-title":"Correlation Between Radiologic Depth of Invasion and Pathologic Depth of Invasion in Oral Cavity Squamous Cell Carcinoma: A Systematic Review and Meta\u2010Analysis","volume":"136","author":"Lee M. K.","year":"2023","journal-title":"Oral Oncology"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.oraloncology.2022.106273","article-title":"Preoperative Evaluation of Depth of Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta\u2010Analysis","volume":"136","author":"Voizard B.","year":"2023","journal-title":"Oral Oncology"},{"issue":"4","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1148\/radiographics.16.4.8835972","article-title":"CT and MR Imaging of Squamous Cell Carcinoma of the Tongue and Floor of the Mouth","volume":"16","author":"Sigal R.","year":"1996","journal-title":"Radiographics"},{"issue":"3","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/his.14291","article-title":"Depth of Invasion Versus Tumour Thickness in Early Oral Tongue Squamous Cell Carcinoma: Which Measurement Is the Most Practical and Predictive of Outcome?","volume":"79","author":"Salama A. M.","year":"2021","journal-title":"Histopathology"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.oraloncology.2019.104461","article-title":"Understanding Approaches to Measurement and Impact of Depth of Invasion of Oral Cavity Cancers: A Survey of American Head and Neck Society Membership","volume":"99","author":"Bulbul M. G.","year":"2019","journal-title":"Oral Oncology"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.oraloncology.2020.104895","article-title":"Assessment of Tumour Depth in Early Tongue Cancer: Accuracy of MRI and Intraoral Ultrasound","volume":"110","author":"Noorlag R.","year":"2020","journal-title":"Oral Oncology"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.oraloncology.2024.107104","article-title":"Are we Ready to Use Ultrasounds in the Clinical Assessment of Depth of Invasion and Tumor Thickness in Oral Squamous Cell Carcinoma? Results From a Systematic Review, Meta\u2010Analysis and Trial Sequential Analysis","volume":"159","author":"Esperouz F.","year":"2024","journal-title":"Oral Oncology"},{"issue":"8","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"2981","DOI":"10.1007\/s00405-020-06421-w","article-title":"Intraoral Ultrasonography in the Assessment of DOI in Oral Cavity Squamous Cell Carcinoma: A Comparison With Magnetic Resonance and Histopathology","volume":"278","author":"Filauro M.","year":"2021","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"issue":"3","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"20180220","DOI":"10.1259\/dmfr.20180272","article-title":"Undetectability of Oral Tongue Cancer on Magnetic Resonance Imaging; Clinical Significance as a Predictor to Avoid Unnecessary Elective Neck Dissection in Node Negative Patients","volume":"48","author":"Baba A.","year":"2019","journal-title":"Dento Maxillo Facial Radiology"},{"issue":"10","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"1896","DOI":"10.3174\/ajnr.A5782","article-title":"Radiologic\u2010Pathologic Correlation of Tumor Thickness and Its Prognostic Importance in Squamous Cell Carcinoma of the Oral Cavity","volume":"39","author":"Weimar E. A. M.","year":"2018","journal-title":"AJNR. American Journal of Neuroradiology"},{"issue":"6","key":"e_1_2_11_23_1","first-page":"736","article-title":"Correlation and Accuracy of Contrast\u2010Enhanced Computed Tomography in Assessing Depth of Invasion of Oral Tongue Carcinoma","volume":"50","author":"Chin S. Y.","year":"2021","journal-title":"International Journal of Oral and Maxillofacial Surgery"},{"issue":"12","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.3174\/ajnr.A5409","article-title":"Setting the Stage for 2018: How the Changes in the American Joint Committee on Cancer\/Union for International Cancer Control Eighth Edition Impact Radiologists","volume":"38","author":"Glastonbury C. M.","year":"2017","journal-title":"AJNR. American Journal of Neuroradiology"},{"issue":"11","key":"e_1_2_11_25_1","first-page":"5741","article-title":"Diagnostic Accuracy of CT and MRI for Mandibular Invasion in Oral Cavity Carcinoma: A Histopathology\u2010Correlated Study","volume":"282","author":"Gill N.","year":"2025","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"key":"e_1_2_11_26_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejrad.2020.109480","article-title":"Measurement Variations of MRI and CT in the Assessment of Tumor Depth of Invasion in Oral Cancer: A Retrospective Study","volume":"135","author":"Waech T.","year":"2021","journal-title":"European Journal of Radiology"},{"issue":"4","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1002\/hed.25532","article-title":"Preoperative Assessment of CD44\u2010Mediated Depth of Invasion as Predictor of Occult Metastases in Early Oral Squamous Cell Carcinoma","volume":"41","author":"Morand G. B.","year":"2019","journal-title":"Head & Neck"},{"issue":"2","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1001\/jamaoto.2023.4049","article-title":"Oral Cavity Cancer Surgical and Nodal Management: A Review From the American Head and Neck Society","volume":"150","author":"Eskander A.","year":"2024","journal-title":"JAMA Otolaryngology. Head & Neck Surgery"},{"issue":"1","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"20988","DOI":"10.1038\/s41598-021-00398-0","article-title":"MRI Before Biopsy Correlates With Depth of Invasion Corrected for Shrinkage Rate of the Histopathological Specimen in Tongue Carcinoma","volume":"11","author":"Harada H.","year":"2021","journal-title":"Scientific Reports"},{"issue":"7","key":"e_1_2_11_30_1","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1001\/jamaoto.2023.1201","article-title":"Margins in Stage I and II Oral Cavity Squamous Cell Carcinoma: A Review From the American Head and Neck Society","volume":"149","author":"Puram S. V.","year":"2023","journal-title":"JAMA Otolaryngology. Head & Neck Surgery"},{"issue":"4","key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1002\/(SICI)1097-0347(199707)19:4<281::AID-HED6>3.0.CO;2-X","article-title":"Quantification of Surgical Margin Shrinkage in the Oral Cavity","volume":"19","author":"Johnson R. E.","year":"1997","journal-title":"Head & Neck"}],"container-title":["Head & Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70370","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.70370","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T04:29:37Z","timestamp":1784953777000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.70370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":30,"alternative-id":["10.1002\/hed.70370"],"URL":"https:\/\/doi.org\/10.1002\/hed.70370","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"assertion":[{"value":"2026-03-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hed.70370"}}