Evaluation of treatment response in oral chronic graft-versus-host patients by power doppler ultrasound: a prospective study.

OBJECTIVE: To date, imaging and non-invasive examination methods for evaluating the oral tissue of patients who with oral chronic graft-versus-host disease (GVHD) are still lacking. Herein, we assessed the ultrasonography imaging characteristics of chronic GVHD patients' buccal soft tissue and evaluated the response to treatment using gray-scale and power Doppler (PD) ultrasound. The overall objective of the study was to determine the potential of ultrasonography to provide an early and objective indication of a therapeutic response to treatment intervention in oral chronic GVHD. METHODS: Buccal mucosa in 21 patients with clinically diagnosis of oral chronic GVHD were assessed before and after 14 day treatment between 2016 and 2018. Ultrasonography assessment included thickness and echogenicity evaluation, and PD. Echogenicity and PD were measured and scored according to a semi-quantitative method. Ultrasonography parameters were compared with clinical activity assessments of disease activity and patient-reported measures. RESULTS: Following 14 day therapy, a significant decrease in PD scores and patient-reported measures was observed (p < 0.01), and clinical assessment scores also decreased (p < 0.05). Changes from baseline PD scores correlated significantly with patient-reported measures (r = 0.85, p < 0.01). Changes in PD scores correlated moderately with the changes in the clinical assessments from baseline (r = 0.46, p < 0.05). A significant decrease in PD scores was observed in the buccal soft tissue of patients that responded clinically to the treatment. A significant decrease in PD scores was also observed in patients that were failed to show clinical improvement (p < 0.05). CONCLUSION: Ultrasonography is a novel and feasible imaging technique for measurement of the response of oral chronic GVHD to therapy. Ultrasonography yields additional information about buccal mucosa and is a complementaty to clinical examination.

Buccal Mucosa Assessed by Ultrasonography in Healthy Adults: Methodology and Determination of Normal Appearance.

The aim of the work described here was to compare intra-oral and transcutaneous ultrasonography (US) scanning and to determine the normal values of buccal mucosa thickness and echogenicity. A total of 190 volunteers underwent US examination of the buccal mucosa. The thickness of the buccal epithelial layer was recorded in 19 subjects via both intra-oral and transcutaneous methods. Overall, 171 healthy adults were examined through intra-oral US. Buccal epithelial layer measurement was unreliable via the transcutaneous method (p = 0.001). The mean time required for visualizing the buccal mucosa was 75 and 171s with intra-oral and transcutaneous US, respectively (p < 0.001). The thickness of the buccal epithelial layers significantly differed with age and sex (p < 0.001), and was positively correlated with height, weight and body surface area. Intra-oral US was proposed as a conventional method for examination of the buccal mucosa. Normal buccal epithelial thickness in adults is associated with age, sex, height, weight and body surface area.