Staging of Squamous Cell Carcinoma of the Oral Cavity and Oropharynx: A Comparison of MRI and CT in T- and N-Staging

Abstract

For T-staging, MR scanning is overall more accurate than CT. If degraded images and T1 tumours are excluded, the techniques are comparable. MR scanning is oversensitive for recurrent disease. For N-staging, all methods failed to detect small metastatic deposits.

Spiral CT of the neck: When do neck malignancies delineate best during contrast enhancement?

“…Recently published comparative studies on CT vs MRI for T-staging of neck primaries showed both techniques to be generally comparable [6,7]. Although not part of this study, it is noted that improvements of spiral CT technique (such as general attempts to achieve an optimum tumor contrast) may particularly improve the accuracy of CT for a more favorable comparison with novel MRI techniques.…”

“…3 The CT scans of a T3-supraglottic carcinoma (arrowhead) a 34 s, b 64 s, and c 88 s after the start of the injection of intravenous contrast material. Note the contrast performance between the tumor boundary and the right thyrohyoid muscle, and that the contrast is better at 64 and 88 s rather than at 34 s eter and/or an exact diagnosis of all infiltrated (sub-)regions [5,6,7,8,9]. Moreover, they do not take account of the increasing importance of exact volume determinations of such primaries for the prognosis and for therapy control after surgery, radiation, and/or chemotherapy [10,11,12,13,14].…”

“…Moreover, one group states that the detection of cervical lymph nodes has much greater importance than the detection and/or exact diagnosis of primaries during CT of the neck [4]. However, in light of a mostly diameter-and/or (sub-)region-based T-staging [5,6,7,8,9] and the increasing importance of volume determinations [10,11,12,13,14] of neck primaries, we think that an optimum tumor contrast is mandatory. Therefore, we performed this study in order to obtain time±density curves of all relevant cervical structures, including neck tumors, using a standard single-bolus technique.…”

Is integrated 18F-FDG PET/MRI superior to 18F-FDG PET/CT in the differentiation of incidental tracer uptake in the head and neck area?

“…As MRI is superior to CT in terms of accuracy in tumor border delineation and is less susceptible to beam hardening artifacts by dental implants (12)(13)(14), many institutions prefer MRI over CT for imaging the head and neck. By combining functional and morphologic imaging, PET/CT is able to increase the sensitivity compared with morphologic imaging alone and has therefore been included in the latest guidelines for head and neck cancer imaging (5,6).…”

Pilocarpine and Prevention of Radiation Induced Xerostomia in HNSCC

“…Having no threshold dose, the magnitude depends both on the volume of salivary tissue irradiated and dose of radiation delivered. Xerostomia and its associated symptoms have a considerable, negative global impact, resulting in shame, anxiety, disappointments and verbal communication difficulties [1][2][3]. Treatment of radiation induced xerostomia calls for good hydration, optimal oral hygiene and prophylaxis of candidiasis.…”