6.6.7: 7. Imaging

Imaging is only required if it may change management

Imaging of Primary

• T1 / T2
  • Minority require imaging
  • Consider for anterior commissure tumours if concern about thyroid cartilage invasion

• T3/4
  • CT / MRI rarely helpful if total laryngectomy planned
  • CT / MRI recommended if chemoradiation or partial laryngectomy considered
    • Thyroid cartilage
    • Paraglottic extension
    • Pre-epiglottic space involvement if supracricoid laryngectomy planned
    • Staging of cervical nodes

• If primary radiation considered: Ultrasound, CT or MRI of larynx to exclude thyroid cartilage invasion

Cervical metastases

• N0 neck: No need to image if elective neck dissection planned or for T1 cancers
• N+ neck: Image (U/S or CT) if concern about resectability

Distant metastases: CXR / CT chest: T2 – 4 cancers

Synchronous primary: CXR / CT chest

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