Imaging plays a vital role in the management of oral cancer. Intraoral ultrasonography （intraoral US） has recently garnered increased attention due to improvements in resolution, miniaturization, and affordability, making it suitable for point-of-care （POC） diagnosis performed at the bedside or chairside by oral cancer clinicians themselves.
This review, presented at the 43rd Annual Meeting of the Japanese Society of Oral Oncology, systematically examines whether intraoral US is recommended over MRI for accurate assessment of depth of invasion （DOI） in tongue cancer patients.
Following the GRADE framework, we formulated a clinical question using PECO criteria and searched PubMed. Four observational studies comparing US and MRI with pathological DOI using Bland-Altman analysis were selected. All studies demonstrated that US measurements more closely matched pathological DOI than MRI. A Summary of Findings, GRADE Evidence Profile, and an Evidence to Decision （EtD） framework were developed to evaluate the overall quality of evidence, considering clinical benefits, harms, patient preferences, cost, and feasibility. The evidence suggested that MRI may overestimate DOI, particularly in superficial lesions, while US may underestimate DOI in thicker tumors.
Based on these findings, we propose a conditional recommendation favoring intraoral US over MRI for DOI evaluation in patients with tongue cancer, with moderate certainty of evidence.

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According to data compiled from the National Malignancy Registry Report of the Head and Neck Cancer Society, the annual distribution of oral cancer stages has not changed in the last 20 years, and advanced cancers remain common. Conversely, the proportion of patients diagnosed and treated with early-stage disease in the oro- and hypopharynx is increasing.
To enable the early diagnosis of oral cancer, it is necessary to accumulate and study clinical and basic medical data on the pathogenesis of early-stage cancer and its precursor lesions. However, unlike superficial cancer of the pharynx, oral superficial carcinoma has not yet been defined. Therefore, we examined oral epithelial dysplasia （OED）, intraepithelial carcinoma （CIS） and submucosal squamous cell carcinoma （SCC-SM） collectively as “oral superficial lesions.”
The gold standard for diagnosing superficial oral lesions is histological biopsy, and cytology can be used to confirm the diagnosis, although sampling from the center of the lesion is important. There is no clear consensus on the therapeutic management of OED; however, it is important to note that malignant transformation can occur even in lesions with mild dysplasia or in the absence of OED.
This paper reports on the current status and issues regarding the diagnosis and treatment of superficial oral lesions.

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