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
Index: Clinical Practice Guidelines for Oropharyngeal Cancer
Resource Appropriate Oropharyngeal Cancer Guideline Scenarios
