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Medicine LibreTexts

7. Imaging

  • Page ID
    18409
  • 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