Department of Radiology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom.
Department of Radiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom.
Eur J Radiol. 2024 Jul;176:111494. doi: 10.1016/j.ejrad.2024.111494. Epub 2024 May 4.
Oral cavity cancer, primarily squamous cell carcinoma (SCC), is a prevalent malignancy globally, necessitating accurate clinical assessment and staging to enable effective treatment planning. Diagnosis requires biopsy and is followed by surgical resection and reconstruction as the primary therapeutic modality. Imaging plays a pivotal role during this process, aiding in the evaluation of tumour extent, nodal involvement and distant metastases. However, despite its value, both radiologists and clinicians must recognise its inherent limitations.
This pictorial review article aims to illustrate the application of various imaging modalities in the pre-treatment evaluation of oral cavity SCC and highlights potential pitfalls. It underscores the importance of understanding the anatomical subsites of the oral cavity, the diverse patterns of spread tumours exhibit at each site, alongside the role of imaging in facilitating informed management strategies, while also acknowledging its limitations.
The review delves into fundamentals of current staging including nodal involvement, while, emphasising imaging strategies and potential limitations. Finally, it touches on the potential of novel radiomic techniques in characterising tumours and predicting treatment response.
Pre-treatment oral cavity cancer staging reflects an ongoing quest for enhanced diagnostic accuracy and prognostic prediction. Recognising the value of imaging alongside its limitations fosters a multidisciplinary approach to treatment planning, ultimately improving patient outcomes.
口腔癌主要为鳞状细胞癌（SCC），在全球范围内较为普遍，需要准确的临床评估和分期，以制定有效的治疗计划。诊断需要进行活检，随后采用手术切除和重建作为主要治疗方式。在这个过程中，影像学发挥着关键作用，有助于评估肿瘤的范围、淋巴结受累情况和远处转移。然而，尽管影像学具有重要价值，但放射科医生和临床医生都必须认识到其固有局限性。
本影像学综述旨在阐述各种影像学在口腔 SCC 术前评估中的应用，并强调潜在的陷阱。文中强调了理解口腔解剖亚部位、肿瘤在每个部位表现出的不同扩散模式以及影像学在制定知情管理策略中的作用的重要性，同时也承认其局限性。
本综述深入探讨了当前分期的基本原理，包括淋巴结受累情况，同时强调了影像学策略及其潜在局限性。最后，还探讨了新型放射组学技术在肿瘤特征描述和治疗反应预测方面的潜力。
术前口腔癌分期反映了对提高诊断准确性和预后预测的持续追求。认识到影像学的价值及其局限性有助于促进治疗计划的多学科方法，最终改善患者的治疗效果。
