{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:11:08Z","timestamp":1781874668153,"version":"3.54.5"},"reference-count":35,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T00:00:00Z","timestamp":1699056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordic Foundation","doi-asserted-by":"publisher","award":["NNF20OC0059290"],"award-info":[{"award-number":["NNF20OC0059290"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Magnetic resonance imaging (MRI) is the preferred imaging modality for oropharyngeal cancers (OPCs), but it has difficulties distinguishing between small OPCs and unilateral tonsil hypertrophy. We hypothesized that surgeon-performed transoral ultrasound (US) could be used to accurately detect T-stage OPCs. We performed a single-center prospective diagnostic accuracy study including patients with suspected or biopsy-verified OPCs during outpatient appointments. All patients were offered transoral US and MRI. If transoral US could not be tolerated by the patient, transcervical US was performed. The primary outcome was the diagnostic accuracy of detecting OPCs with US compared to MRI, using histopathology as the reference standard. The secondary outcome was comparing the primary tumor diameters between US and MRI blinded to each other. Out of the 26 patients included in the study, 21 (81%) had OPCs. Transoral US could be performed in 21\/21 and 1\/5 patients with suspected palatine and lingual tonsil OPCs, respectively. Overall, US diagnostic accuracy was 92%, compared to 81% with MRI (p = 0.37). US and MRI had a high correlation between tumor diameters in the anteroposterior diameter (R = 0.80, p &lt; 0.001), corresponding to the depth axis on US. In conclusion, this small study showed the promise and feasibility of transoral US to improve the initial clinical evaluations of patients with suspected OPCs.<\/jats:p>","DOI":"10.3390\/cancers15215292","type":"journal-article","created":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T14:51:01Z","timestamp":1699109461000},"page":"5292","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Transoral Ultrasound in the Outpatient Clinic for the Diagnostic Work-Up of Oropharyngeal Cancer: A Feasibility Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3857-8003","authenticated-orcid":false,"given":"Martin","family":"Garset-Zamani","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital\u2014Rigshospitalet, 2100 Copenhagen, Denmark"},{"name":"Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke","family":"Norling","sequence":"additional","affiliation":[{"name":"Department of Radiology, Copenhagen University Hospital\u2014Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoffer Holst","family":"Hahn","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital\u2014Rigshospitalet, 2100 Copenhagen, Denmark"},{"name":"Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina Klitm\u00f8ller","family":"Agander","sequence":"additional","affiliation":[{"name":"Department of Pathology, Copenhagen University Hospital\u2014Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6753-8129","authenticated-orcid":false,"given":"Christian","family":"von Buchwald","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital\u2014Rigshospitalet, 2100 Copenhagen, Denmark"},{"name":"Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3267-3560","authenticated-orcid":false,"given":"Tobias","family":"Todsen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital\u2014Rigshospitalet, 2100 Copenhagen, Denmark"},{"name":"Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark"},{"name":"Copenhagen Academy for Medical Education and Simulation, The Capital Region of Denmark, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1002\/ijc.24339","article-title":"Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: An epidemic of viral-induced carcinoma?","volume":"125","author":"Attner","year":"2009","journal-title":"Int. J. Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4550","DOI":"10.1200\/JCO.2013.50.3870","article-title":"Worldwide Trends in Incidence Rates for Oral Cavity and Oropharyngeal Cancers","volume":"31","author":"Chaturvedi","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1002\/hed.22015","article-title":"Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer\u2014Systematic review and meta-analysis of trends by time and region","volume":"35","author":"Mehanna","year":"2013","journal-title":"Head Neck"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.ejca.2020.04.027","article-title":"The current epidemic of HPV-associated oropharyngeal cancer: An 18-year Danish population-based study with 2169 patients","volume":"134","author":"Zamani","year":"2020","journal-title":"Eur. J. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Carlander, A.F., Jakobsen, K.K., Bendtsen, S.K., Garset-Zamani, M., Lynggaard, C.D., Jensen, J.S., Gr\u00f8nh\u00f8j, C., and Buchwald, C.v. (2021). A Contemporary Systematic Review on Repartition of HPV-Positivity in Oropharyngeal Cancer Worldwide. Viruses, 13.","DOI":"10.3390\/v13071326"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1002\/ijc.22464","article-title":"HPV integration begins in the tonsillar crypt and leads to the alteration of p16, EGFR and c-myc during tumor formation","volume":"120","author":"Kim","year":"2007","journal-title":"Int. J. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1001\/jamaoto.2017.2916","article-title":"Prevalence of high-risk human papillomavirus in tonsil tissue in healthy adults and colocalization in biofilm of tonsillar crypts","volume":"144","author":"Rieth","year":"2018","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s12105-012-0374-3","article-title":"Radiographic Imaging of Human Papillomavirus Related Carcinomas of the Oropharynx","volume":"6","author":"Corey","year":"2012","journal-title":"Head Neck Pathol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Blanco, R.G.F., Califano, J., Messing, B., Richmon, J., Liu, J., Quon, H., Neuner, G., Saunders, J., Ha, P.K., and Sheth, S. (2014). Transcervical Ultrasonography Is Feasible to Visualize and Evaluate Base of Tongue Cancers. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0087565"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/j.oraloncology.2014.03.015","article-title":"The use of ultrasound in the search for the primary site of unknown primary head and neck squamous cell cancers","volume":"50","author":"Fakhry","year":"2014","journal-title":"Oral Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1177\/0194599814549181","article-title":"Transcervical ultrasound identifies primary tumor site of unknown primary head and neck squamous cell carcinoma","volume":"151","author":"Mydlarz","year":"2014","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.2214\/AJR.15.14299","article-title":"Visualization of the Oropharynx with Transcervical Ultrasound","volume":"205","author":"Coquia","year":"2015","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.oraloncology.2018.01.016","article-title":"Evaluating oropharyngeal carcinoma with transcervical ultrasound, CT, and MRI","volume":"78","author":"Faraji","year":"2018","journal-title":"Oral Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2658","DOI":"10.1002\/cncr.32799","article-title":"Transcervical sonography and human papillomavirus 16 E6 antibodies are sensitive for the detection of oropharyngeal cancer","volume":"126","author":"Wood","year":"2020","journal-title":"Cancer"},{"key":"ref_15","first-page":"247","article-title":"Endoral sonography in comparison with transcutaneous sonography, computerized tomography and magnetic resonance tomography","volume":"39","author":"Nitsche","year":"1991","journal-title":"HNO"},{"key":"ref_16","first-page":"329","article-title":"Intra-oral sonography in neoplasms of the mouth and base of the tongue","volume":"37","author":"Iro","year":"1989","journal-title":"HNO"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1002\/lary.29525","article-title":"Surgeon-performed Transoral Ultrasound-Guided Aspiration of Peritonsillar Abscess","volume":"131","author":"Todsen","year":"2021","journal-title":"Laryngoscope"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"102768","DOI":"10.1016\/j.amjoto.2020.102768","article-title":"Otorhinolaryngologist performed transcervical versus transoral ultrasonography in the management of peritonsillar abscess","volume":"42","author":"Todsen","year":"2021","journal-title":"Am. J. Otolaryngol."},{"key":"ref_19","first-page":"B5421","article-title":"Surgeon-performed ultrasonography","volume":"64","author":"Todsen","year":"2017","journal-title":"Dan. Med. J."},{"key":"ref_20","unstructured":"Orloff, L.A. (2017). Head and Neck Ultrasonography: Essential and Extended Applications, Plural Publishing, Inc.. [2nd ed.]."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s10396-022-01266-8","article-title":"Point-of-care ultrasound in the head and neck region","volume":"49","author":"Furukawa","year":"2022","journal-title":"J. Med. Ultrason."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"h5527","DOI":"10.1136\/bmj.h5527","article-title":"STARD 2015: An updated list of essential items for reporting diagnostic accuracy studies","volume":"351","author":"Bossuyt","year":"2015","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e012799","DOI":"10.1136\/bmjopen-2016-012799","article-title":"STARD 2015 guidelines for reporting diagnostic accuracy studies: Explanation and elaboration","volume":"6","author":"Cohen","year":"2016","journal-title":"BMJ Open"},{"key":"ref_24","unstructured":"DAHANCA (2021, October 01). DAHANCA Head and Neck Cancer Guidelines for Fast Track Work-Up. Available online: https:\/\/www.dahanca.dk\/CA_Adm_Web_Page?WebPageMenu=1&CA_Web_TabNummer=0."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Brierley, J.D., Gospodarowicz, M.K., and Wittekind, C. (2017). TNM Classification of Malignant Tumours, Wiley. [8th ed.].","DOI":"10.1002\/9780471420194.tnmc26.pub3"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"f2778","DOI":"10.1136\/bmj.f2778","article-title":"Diagnostic accuracy studies: How to report and analyse inconclusive test results","volume":"346","author":"Shinkins","year":"2013","journal-title":"BMJ"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.oraloncology.2018.06.013","article-title":"Oropharyngeal cancer is no longer a disease of younger patients and the prognostic advantage of Human Papillomavirus is attenuated among older patients: Analysis of the National Cancer Database","volume":"83","author":"Rettig","year":"2019","journal-title":"Oral Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1002\/hed.25585","article-title":"Changes in incidence and prevalence of human papillomavirus in tonsillar and base of tongue cancer during 2000\u20132016 in the Stockholm region and Sweden","volume":"41","author":"Haeggblom","year":"2018","journal-title":"Head Neck"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4003","DOI":"10.1007\/s00405-017-4748-8","article-title":"Human papillomavirus in oropharyngeal squamous cell carcinoma in South-Eastern Norway: Prevalence, genotype, and survival","volume":"274","author":"Fossum","year":"2017","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s11282-021-00533-7","article-title":"A comparative study between CT, MRI, and intraoral US for the evaluation of the depth of invasion in early stage (T1\/T2) tongue squamous cell carcinoma","volume":"38","author":"Takamura","year":"2022","journal-title":"Oral Radiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2943","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","year":"2021","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.3389\/fonc.2019.01571","article-title":"Magnetic Resonance vs. Intraoral Ultrasonography in the Preoperative Assessment of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis","volume":"9","author":"Marchi","year":"2020","journal-title":"Front. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1017\/S002221511600044X","article-title":"Tumour assessment and staging: United Kingdom National Multidisciplinary Guidelines","volume":"130","author":"Roland","year":"2016","journal-title":"J. Laryngol. Otol."},{"key":"ref_34","first-page":"1654","article-title":"Biopsy of deep-seated head and neck lesions under intraoral ultrasound guidance","volume":"27","author":"Wong","year":"2006","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1002\/jcu.1039","article-title":"Intraoral sonographic evaluation of parapharyngeal space tumors","volume":"29","author":"Rebol","year":"2001","journal-title":"J. Clin. Ultrasound"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/21\/5292\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:17:42Z","timestamp":1760131062000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/21\/5292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,4]]},"references-count":35,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["cancers15215292"],"URL":"https:\/\/doi.org\/10.3390\/cancers15215292","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,4]]}}}