6.4.6: 6. Imaging
- Page ID
- 18327
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A minority of submandibular tumours require imaging
Indications
- Suspected non-neoplastic disease e.g. sialadenitis, sialolithiasis (US / CT)
- Distinguish between submandibular lymph node and salivary mass (US)
- Reduced mobility/fixed tumour with invasion of surrounding structures (Panorex / CT / MRI)
- Neurological deficits to determine extent of perineural invasion (MRI with Gd)
- Malignant tumour (clinically / cytologically) to exclude cervical metastases (US / CT)
- Exclude lung metastases with suspected/known malignancy (CXR / CT)
Panorex: For adherence to mandible
Ultrasound
- Sialolithiasis / chronic sialadenitis / neoplasm
- Cervical lymph nodes
CT
- Sialolithiasis / chronic sialadenitis / neoplasm
- Cystic vs solid
- Cervical lymph nodes
- Advanced tumours: Erosion of mandible / invasion of muscles of floor of mouth / tongue
MRI
- Advanced tumours: Erosion of mandible / invasion of muscles of floor of mouth or tongue (Good soft tissue differentiation)
- Perineural invasion
PET-CT: Unhelpful as benign pathology (pleomorphic adenoma, infection), lymphoma are PET-avid