Imaging of Oral Cavity Cancer

An Exploration of Anatomy, Staging, and Imaging Findings

Introduction

Dr. Gold Moniz, a world-renowned hedonic neuroradiologist, presents on the imaging of oral cavity cancer.
Dr. Moniz is the director of the Head and Neck Imaging Fellowship Program and an associate professor at Columbia University Medical Center in New York.
She has taught residents and fellows in Boston and New York, earning a well-respected reputation in the field of education.
The topic of today's presentation is the imaging of oral cavity cancer, particularly relevant in regions like Tanzania where it is more prevalent.

The oral cavity is the most anterior subdivision of the aerodigestive tract.
It can be divided into the oral cavity proper and the vestibule.
Different sub-sites within the oral cavity include the tongue, buccal mucosa, alveolar ridge, hard palate, and floor of mouth.
Understanding the anatomy is crucial for accurate interpretation of imaging studies.

Staging of oral cavity cancer is done according to the AJCC classification system.
The 8th edition introduced the concept of depth of invasion for oral tongue cancers.
Factors considered for staging include tumor size, invasion of surrounding structures, and lymph node involvement.
Accurate staging helps determine appropriate treatment options.

Oral tongue cancer is primarily located on the lateral margins or undersurface of the tongue.
Depth of invasion is a crucial prognostic factor for oral tongue cancer.
Additional imaging considerations include involvement of the lingual septum, midline crossing, and invasion of adjacent structures.
Key findings to look for include bone involvement, perineural extension, and lymph node metastasis.

Buccal mucosa cancer commonly presents as thickening of the mucosa in the cheek region.
Puff cheek technique and oblique imaging can help visualize subtle lesions.
Important imaging considerations include detection of bone involvement, extension into the retromolar trigon, and invasion of adjacent structures.
Look for features like rounded lymph nodes, perineural spread, and parotid gland involvement.

Alveolar ridge and hard palate cancers often exhibit bone involvement.
Extension along the greater palatine foramen and the masticator space should be evaluated.
Detection of perineural spread and invasion of adjacent structures is crucial.
MRI imaging is preferred for assessing soft tissue extension.

Imaging plays a vital role in the evaluation and staging of oral cavity cancer.
Accurate assessment of depth of invasion, bone involvement, and extension into adjacent structures guides treatment decisions.
Collaboration between radiologists, surgeons, and radiation oncologists is essential for optimal patient care.
Continued research and advancements in imaging techniques contribute to improved outcomes for patients.