6.9.10: 10. Imaging
- Page ID
- 53887
\( \newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \) \( \newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}} \)\(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\) \(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\)\(\newcommand{\AA}{\unicode[.8,0]{x212B}}\)
Imaging for Oropharyngeal Cancer
Imaging only required if it may change management
Distant pulmonary metastases / synchronous primary: CXR / CT chest
If radiation planned
- Panorex to exclude dental disease or bone destruction
- Imaging (CT/ MRI) to plan radiation
Imaging of Primary
- T1: Rarely require imaging
- T2: Consider CT scan prior to transoral resection to determine position of carotid artery
- T3
- Trismus: Rule out involvement of masticator space, PPS and ITF (CT scan)
- If abuts mandible to decide about marginal / segmental / hemimandibulectomy (CT / Panorex)
- Choice 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 about occult contralateral (base of tongue, soft palate) or retropharyngeal nodes
- N+ neck: Image (U/S or CT) if concern about resectability