Essentials on Oncological Imaging: Postoperative Computed Tomography and Magnetic Resonance Imaging of Oral Tongue Cancer

Abstract

The contribution of diagnostic imaging in evaluating the pre- and postoperative status of tongue cancer is essential. Interpretation of postoperative images is made difficult by deformation; therefore, it is necessary to know how surgical technique, biological reaction, postoperative anatomy, and local recurrence are reflected on the images. This study explains the postoperative imaging features of tongue cancer to help in the early detection of local recurrence and avoid inappropriate treatment. We review schematic drawings of representative surgical procedures for tongue carcinoma, variable radiological features in postoperative conditions with or without complications, and typical features of local failures and their mimics. This article clarifies the important tasks of radiologists and clinicians in the postoperative evaluation of tongue carcinoma.

ADC for Differentiation between Posttreatment Changes and Recurrence in Head and Neck Cancer: A Systematic Review and Meta-analysis

“…CT, MR imaging, and [ 18 F] FDG-PET/CT are the main diagnostic imaging modalities used during follow-up after treatment of head and neck cancer, primarily to detect recurrent lesions and differentiate them from posttreatment changes. 4 Although there have been publications on imaging findings that can help distinguish posttreatment recurrence from posttreatment changes in head and neck cancer, [1][2][3] anatomic and radiologic modifications associated with treatment can sometimes make image interpretation difficult in clinical practice. CT is the standard imaging technique for follow-up evaluation in many institutions because of its better accessibility, ability to provide a broader imaging range, efficiency, and higher temporal sensitivity profile.…”

“…Posttreatment changes in anatomic architecture due to edema, inflammation, and fibrosis occur frequently and can mimic recurrent lesions. Thus, differentiation between recurrent lesions and posttreatment changes can be difficult, making the interpretation of follow-up imaging after treatment of head and neck cancer difficult, [1][2][3] sometimes necessitating tissue biopsies for pathologic confirmation. PET/CT and contrastenhanced CT are the primary imaging modalities for posttreatment head and neck cancer, 4 though MR imaging is sometimes performed in cases that are difficult to differentiate between recurrence and posttreatment changes.…”

What is the consistency between clinical and pathological staging in tongue cancer?

“…Magnetic resonance imaging is a common imaging modality for the analysis of structural and functional analysis of the tongue and neck metastasis. [13][14][15] Navarro et al [14] have shown that MRI is a useful imaging method for preoperative evaluation of tongue cancers and tumor thickness.…”

Normalized Parameters of Dynamic Contrast-Enhanced Perfusion MRI and DWI-ADC for Differentiation between Posttreatment Changes and Recurrence in Head and Neck Cancer

“…Local recurrence is one of the most clinically important forms of recurrence in head and neck cancer, 1 and its early detection is important because it leads to subsequent salvage therapy. Posttreatment changes such as edema, inflammation, and fibrosis may cause difficulty in differentiating recurrences from benign posttreatment changes during followup imaging evaluation, [2][3][4] and tissue biopsy may be required for pathologic confirmation in some patients. Contrast-enhanced CT and PET/CT are the principal imaging modalities for posttreatment evaluation of head and neck cancer; 5 however, patients may undergo MR imaging when it is difficult to distinguish between recurrence and posttreatment changes.…”