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This single-center prospective diagnostic accuracy feasibility study evaluates surgeon-performed transoral ultrasound using high-resolution, small-footprint transducers during outpatient visits, comparing ultrasound against magnetic resonance imaging with histopathology as the reference. Among 26 included patients, ultrasound achieved 92% diagnostic accuracy versus 81% for MRI, with high correlation in tumor diameter measurements. 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Transoral Ultrasound in the Outpatient Clinic for the Diagnostic Work-Up of Oropharyngeal Cancer: A Feasibility Study. Cancers 2023, 15, 5292. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers15215292  \nAcademic Editors: Alessandro Villa and Noah S. Kalman  \nReceived: 5 October 2023  \nRevised: 1 November 2023  \nAccepted: 1 November 2023  \nPublished: 4 November 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark  \n2 Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark  \n3 Department of Radiology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark  \n4 Department of Pathology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark  \n5 Copenhagen Academy for Medical Education and Simulation, The Capital Region of Denmark, 2100 Copenhagen, Denmark  \n* [Correspondence: martin.garset-zamani@regionh.dk](Correspondence: martin.garset-zamani@regionh.dk)  \nSimple Summary: Oropharyngeal cancers may be difficult to detect with current clinical and radiographic examinations. This study explores whether a new transoral ultrasound technique using high-resolution, small-footprint ultrasound transducers can improve the detection and staging of oropharyngeal cancers in an outpatient setting. We found that clinicians can use transoral ultrasound to improve the diagnostic workup of oropharyngeal cancers with an accuracy comparable to magnetic resonance imaging.  \nAbstract: 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 \u003C 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.  \nKeywords: oropharyngeal cancer; head and neck cancer; squamous cell carcinoma; human papillomavirus; head and neck ultrasound; transoral ultrasound; intraoral ultrasound; transcervical ult","cbCaiau4wLrmasKO","https://ap.wps.com/l/cbCaiau4wLrmasKO","pdf",6163302,"English","# Simple Summary\n# Abstract\n# Keywords\n# 1. Introduction\n## Background on HPV-associated OPC incidence\n## Imaging challenges with MRI/CT\n## Prior transcervical ultrasound approaches\n## Rationale for high-frequency transoral small-footprint ultrasound","[{\"question\":\"What is the purpose of transoral ultrasound in this outpatient study?\",\"answer\":\"The study explores whether surgeon-performed transoral ultrasound can improve diagnostic work-up by accurately detecting T-stage oropharyngeal cancers in an outpatient setting.\"},{\"question\":\"How did the study compare ultrasound with magnetic resonance imaging?\",\"answer\":\"All patients were offered transoral ultrasound and MRI, and diagnostic accuracy was assessed using histopathology as the reference standard. Secondary analysis compared tumor diameters between ultrasound and MRI with blinding.\"},{\"question\":\"What were the key diagnostic accuracy results?\",\"answer\":\"Ultrasound showed 92% overall diagnostic accuracy versus 81% for MRI, with no statistically significant difference reported (p = 0.37). Tumor diameter measurements on ultrasound and MRI were highly correlated.\"}]","Transoral Ultrasound in the Outpatient Clinic for the Diagnostic Work-Up of Oropharyngeal Cancer: A Feasibility Study | PDF",1790253956]