Tongue cancer MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [3]

Overview

Head and neck MRI scan is diagnostic of tongue cancer. On head and neck MRI, tongue cancer is characterized by isointense to hypointense mass on T1-weighted MRI and isotense to hyperintense mass on T2-weighted MRI.

MRI

MRI can provide more accurate definition of tumors of the tongue and is more sensitive for superficial tumors.^[1]
MRI is also better than CT for discriminating tumor from mucus and in detecting bone marrow invasion.^[2]
MRI can be useful for evaluation of cartilage invasion, particularly for non-ossified cartilage that can pose difficulty for CT.
CT scanning is better than MRI for detection of bone cortex invasion since MRI shows no bony detail.^[3]
MRI is superior to CT for evaluation of perineural spread, skull base invasion, and intracranial extension of head and neck cancer.
MRI may also provide additional benefits compared with CT in the evaluation of the base of tongue and parotid glands. MRI scan is the imaging modality recommended by the National Comprehensive Cancer Network (NCCN) guidelines to evaluate skull base erosion.
noncontrast-enhanced T1-weighted images, contrast-enhanced T1-weighted images with fat suppression, and fat-suppressed fluid-sensitive sequences.
CT scanning outperforms MRI for the detection of pathologic nodal metastases.
MRI is excellent at identifying the extent of tumor infiltration and is especially useful in patients with significant dental amalgam which causes artifact on CT.^[4]


MRI component	Features

T1	Intermediate to low signal
T2	Intermediate to high signal
T1 contrast + gadolinium with fat saturation	Tumors enhance

In larger lesions that abut the mandible, MRI is more sensitive than CT at identifying early marrow change (low T1 signal, high T2 signal, enhancement) but less sensitive at visualising cortical erosion.

MRI of squamous cell carcinoma of tongue with Axial diffusion weighted imaging ^[5]
Axial T1 fat saturated MRI of squamous cell carcinoma of tongue ^[5]
Axial apparent difusion coefficient MRI of squamous cell carcinoma of tongue ^[5]
Coronal T1 MRI of squamous cell carcinoma of tongue ^[5]
Axial T1 fat saturated THINS MRI of squamous cell carcinoma of tongue^[5]
Axial T2 fat saturated MRI of squamous cell carcinoma of tongue^[5]
Axial T2 fat saturated MRI of squamous cell carcinoma of tongue^[5]
Coronal T2 fat saturated MRI of squamous cell carcinoma^[5]
Axial T1 MRI of squamous cell carcinoma of tongue^[5]
Coronal T1 MRI of squamous cell carcinoma of tongue^[5]
Coronal T1 C1 fat saturated MRI of squamous cell carcinoma of tongue^[5]