Article Figures & Data
Figures
- Fig 1.
Survey questions.
- Fig 2.
Contrast-enhanced axial (A) and coronal (B) CT images of a patient with posterior pharyngeal wall cancer. The transaxial dimension is 2.5 cm (short arrow), though the craniocaudal dimension exceeds 4 cm (long arrow). Therefore, based on size alone, the stage is T3. Addition of concurrent chemotherapy to radiation therapy would be appropriate in a T3, but not a T2 lesion. Additional factors that would upstage this tumor, as described in American Joint Committee on Cancer, 7th edition (https://cancerstaging.org/Pages/default.aspx) are extension to the larynx, involvement of extrinsic tongue muscles, medial pterygoid muscle involvement, or hard palate or mandible invasion. These are all imaging-based characteristics.
- Fig 3.
Contrast-enhanced axial (A) and coronal (B) CT images of a patient with squamous cell carcinoma of the right base of the tongue. Although the transaxial dimension is 1.8 cm (short arrow), the craniocaudal dimension is 3.5 cm, technically at least a T2 lesion, if only the size is considered. These measurements can only be accurately acquired on imaging. Note that the largest craniocaudal dimension (long arrow) is submucosal, and on the basis of physical examination alone, this tumor could be grossly understaged.
- Fig 4.
Axial contrast-enhanced CT at the floor of mouth level. Clinically, this tumor was staged as T2 right oral cavity squamous cell carcinoma because there was mucosal ulceration and a >2-cm palpable mass. However, there is invasion of the lateral and posterior genioglossus muscle (long arrow). Note a normal hyoglossus muscle on the left (short arrow); tumor has completely replaced right hyoglossus muscle. This is upstaged to T4a on the basis of CT findings, changing the prognosis and treatment.
Tables
Variable No. of Responses Frequency Nature of Practice 229 Academic 144 62.8% Private 54 23.8% Both 31 13.5% Years of Experience 229 <2 years 16 7.0% 2–5 years 39 17.0% 5–8 years 29 12.7% >8 years 145 63.3% Subspecialty 229 Head and neck radiology 165 72.1% Other subspecialization of radiology 64 27.9% Answer No. of Responses (n = 227) Frequency Afraid of inaccuracy 134 59.0% Unable to remember staging classification 132 58.2% Time-consuming 106 46.7% Not required 81 35.7% Other 74 32.6% No reimbursement 41 18.1% ↵a The sum of responses exceeds the total number of responses (n = 227) because participants were able to choose multiple answers for this particular question.
Answer No. of Responses (n = 115) Frequency Believe in added value required from surgery or oncology colleagues 60 52.2% Help the treatment decision 50 43.5% Not applicable 40 34.8% Educational value 38 33.0% Other 17 14.8% ↵a The sum of responses exceeds the total number of responses (n = 115) because participants were able to choose multiple answers for this particular question.
Answer No. of Responses (n = 229) Frequency Very important 44 19.2% Somewhat important 68 29.7% Neutral 80 34.9% Not very important 18 7.9% Not important 19 8.3%
