6.8.7: 7. Imaging
- Page ID
- 18409
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Imaging is only required if it may change management
Distant pulmonary metastases / synchronous primary: CXR / CT chest
Radiation planned: Panorex to exclude dental disease or bone destruction
Imaging of Primary
- T1-3 oral cancers
- Minority require imaging
- Abuts mandible to decide re marginal / segmental / hemimandibulectomy
- Trismus to rule out involvement of masticator space, PPS and ITF
- T4 oral cancers
- Resectable?
- Abuts mandible to decide re marginal / segmental / hemimandibulectomy
- Type of bone reconstruction
- Length of bone resection
- Mandibular height
- Will mandibulectomy cross midline?….excludes surgery if cannot reconstruct anterior mandible (Andy Gump deformity)
- Type of imaging
- Soft tissue: CT / MRI
- Bone: Panorex / CT scan / MRI
- Perineural spread: MRI
Cervical metastases
- N0 neck: No need to image if elective neck dissection planned, unless concern re contralateral occult nodes with a midline cancer
- N+ neck: Image (U/S or CT) if concern about resectability