Imaging for Oral Cancer

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

Index: Clinical Practice Guidelines for Oral Cancer

Resource Appropriate Oral Cancer Guideline Scenarios