01 February 2023

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Ultrasound as a tool to investigate intraoral lesions

By Arianna Bianchi

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Currently, pathologies of the oral mucosa are diagnosed through clinical examination and possibly a biopsy. In fact, in the daily practice of oral medicine, there is a lack of routine diagnostic support useful for visualizing the anatomical structures located below the surface of the mucosa.

With a view to increase less invasive medical procedures, therefore, the possibility of having an imaging technique, such as ultrasound, dedicated to the investigation of oral soft tissues and their alterations can play an important support role in the diagnostic process.

Attempts have been made over the years to introduce conventional ultrasound into the diagnostic procedure of pathological conditions of the head and neck. But the extreme variability of the frequencies used and of the acquisition protocols has made it challenging to standardize the results obtained from various studies.

Materials and methods

In a study published in Dentomaxillofacial Radiology in May 2020, the authors set out to evaluate the effectiveness of ultra-high frequency ultrasound (UHFUS) on assessing oral mucosa. 

Initially introduced in the pre-clinical setting and mainly used in the study of animal models, ultra-high-frequency ultrasound has been shown to allow the correlation between ultrasound images and high specific value histology, being able to discriminate healthy and pathological tissues with an accuracy comparable to biopsy.

Results

In the study, the authors set out to describe the structure of the most common sites of localization of oral lesions — tongue, buccal mucosa, gingiva, lips and palate — in order to outline which structures are normally present in the absence of disease.

Conclusions

Although researchers describe this as an explorative evaluation, the study of the oral mucosa using UHFUS appears extremely promising, suggesting a potential role to support the clinician in the daily clinical practice of oral medicine.

Very high frequency ultrasound could therefore represent the "missing link" in the evaluation of the oral mucosa, hopefully becoming a diagnostic support in the management of oral soft tissue lesions in terms of diagnosis, surgical procedure, reduction of post-operative discomfort and of prevention or early diagnosis of malignant transformation.

Further studies are needed to explore all the possibilities of the technique and to validate the intra-oral application of UHFUS and its potential impact on diagnosis and therapy.

For more information: "Discovering a new anatomy: exploration of oral mucosa with ultra-high frequency ultrasound."