By Moni Abraham Kuriakose
This is the second one of 4 volumes that jointly supply an authoritative, in-depth reference consultant protecting all features of the administration of oral melanoma from a multidisciplinary point of view and at the foundation of a robust medical origin. This quantity addresses a variety of administration matters in oral melanoma, from imaging and staging via to the jobs of radiation treatment and chemotherapy. rules of ablative surgical procedure are defined, and neck dissection and sentinel lymph node biopsy concepts, defined. unique attention can also be given to the administration of issues, salvage surgical procedure and re-radiation, the biologic foundation of remedy failure, and rising methods to beat remedy resistance. The inclusion of resource-stratified instructions will meet the wishes of practitioners in several geographic areas with various resources.
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Extra resources for Contemporary Oral Oncology: Diagnosis and Management
Sample text
The MDCT protocol involves the acquisition of 5-mm spiral data with and without intravenous contrast medium with the PCT for lesions of the oral cavity. 625-mm intervals. We display image data in the axial, sagittal, and coronal planes. Dedicated additional curved planes are utilized when there is a requirement for the resolution of specific issues. 40 Fig. 15 Axial CT image (a) shows a left oropharyngeal lesion (star) extending to RMT and anterior infratemporal fossa (black arrow). Curved soft tissue reconstruction (b) revels involvement of anterior fibers of temporalis (triangle) and considerable extension along alveolar margin.
Standard T1 (TSE,TR 600-900ms; TE 8-15ms)- and T2 (TSE TR 8000-9600ms; TE 90-120ms)-weighted images, STIR TR 6000-7000ms; TE 70ms, diffusion-weighted imaging (DWI), and contrast-enhanced fat-saturated images are performed. A section thickness of 3–5 mm is optimal in most situations. We use matrix size of 512x512 and FOV of 18-24cm. For gross nodal assessment a section thickness of 5 mm is adequate. Additional MR techniques for improving the quality of images of the oral cavity involve using spacers within the vestibule of the mouth to separate it from the teeth and the alveolar ridges.
4 Important relationships of the posterior tongue. (b) In the coronal MR image (b) fat planes (solid arrow) are clearly visible between the tongue and medial pterygoid. More anteriorly, the submandibular gland is visible (triangle) absence of distant metastasis (M-stage). 1). Thorough understanding of the biological behavior of the lesion is essential for the radiologist for strategizing imaging requirements. Although uncommon on initial presentation, the presence of distant metastasis and second primary cancers of the upper aerodigestive tract should be evaluated.