Abstract：
Resection margins of oral squamous cell carcinoma (SCC) are often inadequate. A systematic review on clinical intraoperative whole-specimen imaging techniques to obtain adequate deep resection margins in oral SCC is lacking. Such a review may render better alternatives for the current insufficient intraoperative techniques: palpation and frozen section analyses (FSA). This review resulted in ten publications investigating ultrasound (US), four investigating fluorescence, and three investigating MRI. Both US and fluorescence were able to image the tumor intraorally and perform ex-vivo imaging of the resection specimen. Fluorescence was also able to image residual tumor tissue in the wound bed. MRI could only be used on the ex-vivo specimen. The 95 % confidence intervals for sensitivity and specificity were large, due to the small sample sizes for all three techniques. The sensitivity and specificity of US for identifying < 5 mm margins ranged from 0 % to 100 % and 60 % to 100 %, respectively. For fluorescence, this ranged from 0 % to 100 % and 76 % to 100 %, respectively. For MRI, this ranged from 7 % to 100 % and 81 % to 100 %, respectively. US, MRI and fluorescence are the currently available imaging techniques that can potentially be used intraoperatively and which can image the entire tumor-free margin, although they have insufficient sensitivity for identifying < 5 mm margins. Further research on larger cohorts is needed to improve the sensitivity by determining cut-off points on imaging for inadequate margins. This improves the number of adequate resections of oral SCC\'s and pave the way for routine clinical implementation of these techniques.
摘要：
口腔鳞状细胞癌（SCC）的切缘通常不足。缺乏对临床术中全标本成像技术的系统评价，以获得足够的口腔SCC切缘。这样的审查可能为当前不足的术中技术提供更好的替代方案：触诊和冷冻切片分析（FSA）。这篇综述产生了十篇研究超声的出版物(美国)，四个调查荧光，和三个调查MRI。US和荧光都能够在口腔内对肿瘤成像并对切除标本进行离体成像。荧光还能够对伤口床中的残留肿瘤组织成像。MRI只能用于离体标本。敏感性和特异性的95%置信区间较大，由于这三种技术的样本量都很小。US识别<5mm边缘的敏感性和特异性范围为0%至100%和60%至100%,分别。对于荧光，从0%到100%，从76%到100%，分别。MRI,从7%到100%，从81%到100%，分别。US,MRI和荧光是目前可用的成像技术，可以在手术中使用，并且可以对整个无肿瘤边缘进行成像。尽管它们对识别<5mm边距的灵敏度不足。需要对更大的队列进行进一步的研究，以通过确定成像上的截止点来提高灵敏度，以获得不足的边缘。这增加了口腔SCC的适当切除次数，并为这些技术的常规临床实施铺平了道路。
