2016_Head & Neck COURSE BOOK

Daily practice: CT

Radiological work-up

 Female, 89 years  Since several months painful mouth  Examination: – Lesion soft palate – 3,0 cm (T2)

 Chest X-ray – Normal  US Neck

– Normal nodes – No FNAC

 CT Neck

 Biopsy: Squamous cell carcinoma (SCC)

Soft tissue window

Multidisciplinary H&N meeting

 T2N0 maxillar ca.  Treatment

– Partial maxillectomy – Palatal obturator  Path report: verrucous ca. Ø 4,8 cm, near positive surgical ventral margin (<1mm)  Conclusion : – pT3N0M0 – In view of age: clinical follow-up (no post-op RT)

Bone window

Magnetic resonance imaging (MRI)

Objectives

 Advantages: • No radiation

 Ultrasound

• Allergies to iv contrast (Gadolinium) extremely rare • Superior soft tissue contrast (vs. CT) • Less dental filling metallic artifacts

 Panoramic dental X-ray

 Disadvantages:

 CT

• Limited availability; expensive • Long acquisition time => ↑motion degradation • More contraindications (claustrophobia, ICD, CI, etc.)

 MRI

6

6