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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Oral Cavity Anatomy
7 topics, 29 min.
Lesson
Oral Cavity Staging of Squamous Cell Malignancy
18 topics, 1 hr. 26 min.
Principles of T Staging of Oral Cavity Squamous Cell Malignancy
4 m.Principles of N and M Staging of Oral Cavity Squamous Cell Malignancy
6 m.Diagnosis of Oral Tongue Squamous Cell Malignancy
6 m.T Staging of Oral Tongue Squamous Cell Malignancy
6 m.N and M Staging of Oral Tongue Squamous Cell Malignancy
5 m.Diagnosis of Buccal Mucosal Squamous Cell Malignancy
4 m.T Staging of Buccal Mucosal Squamous Cell Malignancy
3 m.N and M Staging of Buccal Mucosal Squamous Cell Malignancy
3 m.Diagnosis of Alveolar Mucosal Squamous Cell Malignancy
7 m.T Staging of Alveolar Mucosal Squamous Cell Malignancy
6 m.Diagnosis of Retromolar Trigone Squamous Cell Malignancy
6 m.T Staging of Retromolar Trigone Squamous Cell Malignancy
5 m.Diagnosis of Hard Palate Squamous Cell Malignancy
4 m.T Staging of Hard Palate Squamous Cell Malignancy
4 m.Diagnosis of Floor of Mouth Squamous Cell Malignancy
9 m.T Staging of Floor of Mouth Squamous Cell Malignancy
6 m.N and M Staging of Floor of Mouth Squamous Cell Malignancy
5 m.Marrow Infiltration and Perineural Infiltration in the Oral Cavity
5 m.Lesson
Lymph Node Levels of the Neck
7 topics, 24 min.
Lesson
Oropharynx
21 topics, 1 hr. 9 min.
Anatomy and Boundaries of the Oropharynx
4 m.Anatomy of the Tongue Base
4 m.Anatomy of the Palatine Tonsil
4 m.Anatomy of the Soft Palate
3 m.Anatomy of the Posterior Oropharyngeal Wall
3 m.Oropharyngeal SCC of the Base of Tongue
4 m.Oropharyngeal Carcinoma: Nodal Drainage and Differential Dx
5 m.Staging Oropharynx Cancer, T-staging
4 m.Staging Oropharynx Cancer, N-Staging
6 m.Oropharynx - Base of Tongue SCC: T-Staging
3 m.Base of Tongue Oropharyngeal Carcinoma, N & M Staging
3 m.Oropharynx - SCC of the Palatine Tonsil
4 m.Oropharynx - Palatine Tonsil SCC: Paths of Spread
5 m.Oropharynx - Lymphadenopathy and HPV-Related SCC
3 m.Oropharynx - Palatine Tonsil SCC - T Staging
4 m.Oropharynx - Palatine Tonsil SCC - N/M Staging
4 m.Oropharynx - SCC of the Soft Palate
3 m.Oropharynx - SCC: Paths of Spread and Differential Dx
4 m.Oropharynx - Soft Palate SCC: Nodal Drainage
2 m.Oropharynx - Soft Palate SCC - TNM Staging
3 m.Oropharynx - Base of Tongue Mucoepidermoid Carcinoma
5 m.Lesson
Hypopharynx
18 topics, 56 min.
Hypopharynx anatomy
4 m.Hypopharynx - The Piriform Sinus Anatomy
5 m.Hypopharynx - The Postcricoid Space Anatomy
4 m.Hypopharynx - The Posterior Hypopharyngeal Wall Anatomy
5 m.Hypopharynx - Piriform Sinus SCC
5 m.Hypopharynx - Piriform Sinus Carcinoma - Local Spread
4 m.Hypopharyngeal SCC - Nodal Drainage
3 m.Hypopharyngeal SCC - Differential Dx
2 m.Hypopharyngeal Carcinoma - T Staging
3 m.Hypopharyngeal SCC - N Staging
3 m.Hypopharynx - Piriform Sinus SCC - T Staging
5 m.Hypopharynx - Piriform Sinus SCC - N/M Staging
4 m.Hypopharynx - Postcricoid Space SCC
4 m.Hypopharynx - Postcricoid Space SCC - Local Spread
4 m.Hypopharynx - Postcricoid SCC - Differential Diagnoses
2 m.Hypopharynx - Postcricoid Space SCC: T Staging
3 m.Hypopharynx - Postcricoid Space SCC - N/M Staging
3 m.Hypopharynx - Changes in AJCC Staging Guidelines
4 m.Lesson
Larynx
18 topics, 1 hr. 3 min.
Larynx Anatomy
5 m.Larynx Anatomy: Supraglottic, Glottic, and Subglottic Sites
9 m.The Supraglottic Larynx
4 m.The Glottic Larynx.
3 m.The Subglottic Larynx
3 m.Laryngeal SCC - T Staging
7 m.Laryngeal SCC - Cartilage Invasion
4 m.Laryngeal SCC: Local and Nodal Extension
4 m.Supraglottic SCC- Differential Diagnoses
3 m.Laryngeal SCC: Glottic Origin
5 m.Larynx - Glottic SCC: Patterns of Local Spread
4 m.Laryngeal SCC of the Subglottis
3 m.Larynx - Subglottic Carcinomas: Patterns of Spread & Differential Dx
3 m.Laryngeal SCC: T Staging
4 m.Larynx - Glottic SCC: T Staging
3 m.Laryngeal SCC: N Staging
2 m.Glottic SCC: T Staging
4 m.Laryngeal SCC: N and M Staging
3 m.Lesson
Sinonasal
5 topics, 14 min.
Lesson
Perineural Tumor Spread
3 topics, 16 min.
0:01
Hello everyone.
0:02
Dr. Sidney Levy, continuing our discussion of the
0:05
staging of laryngeal squamous cell malignancy.
0:08
I'd like to now formally stage our example case of this
0:12
large transglottic, uh, laryngeal squamous cell carcinoma.
0:17
So we've decided in a previous vignette that
0:19
this, uh, tumor is centered on the glottis with
0:23
spread to the supraglottis and to the subglottis.
0:27
Therefore we will use the staging for
0:29
glottic laryngeal squamous cell carcinoma.
0:33
Unlike pharyngeal squamous cell carcinoma,
0:36
the dimensions of the tumor are less important, but should
0:39
nevertheless be measured and quoted in the report.
0:43
Key features which help us stage this tumor are
0:47
the status of soft tissue planes in the supraglottis
0:52
and the status of the thyroid cartilages.
0:56
So in this case, at the level of the vocal cords,
1:03
we can no longer distinguish normal arytenoid cartilages.
1:07
So that's the first thing that I can see here.
1:10
There should be two normal arytenoid
1:13
cartilages here; they are not present.
1:15
At the same level, there is invasion of both the
1:19
inner and outer cortex of the thyroid cartilages.
1:24
This is all abnormal soft tissue tumor,
1:28
all abnormal laryngeal malignancy.
1:32
And indeed, it has taken over
1:35
the arytenoid cartilages as well.
1:39
So based on that knowledge, we already know
1:42
that this tumor is moderately advanced.
1:45
And the reason we know is that it has invaded
1:48
the outer cortex of the thyroid cartilage.
1:51
Possibly also invaded the strap musculature
1:55
overlying that in the anterior neck.
1:58
The only decision that remains for T staging
2:01
is, is it very advanced local disease?
2:04
Does it invade the prevertebral space?
2:07
Does it encase the carotid artery?
2:08
Does it invade the mediastinum?
2:10
It does none of those things,
2:12
so therefore this tumor is a T4A tumor.
2:17
You need to also mention that it is moderately
2:21
to markedly narrowing the airway at this level.
2:24
So there is the potential for an acute emergency.
2:27
And also it is a primarily right-sided
2:32
tumor, but well and truly crossing the
2:34
midline with marked left-sided involvement.
2:38
Whilst the tumor is closely abutting the cricoid cartilage
2:42
inferiorly, it is difficult to say whether it is
2:46
eroded, because we can actually see thyroid
2:50
cartilage on the T2 which is intact, but there is
2:55
some evidence of infiltration on the T1-weighted
2:58
imaging which is likely not partial voluming.
3:01
So, definitely involving thyroid and arytenoid
3:04
cartilages, possibly involving cricoid cartilage as well.
3:09
In our next vignette, we will discuss
3:11
the N staging of this tumor.
Glottic SCC: T Staging
HIDEInteractive Transcript
0:01
Hello everyone.
0:02
Dr. Sidney Levy, continuing our discussion of the
0:05
staging of laryngeal squamous cell malignancy.
0:08
I'd like to now formally stage our example case of this
0:12
large transglottic, uh, laryngeal squamous cell carcinoma.
0:17
So we've decided in a previous vignette that
0:19
this, uh, tumor is centered on the glottis with
0:23
spread to the supraglottis and to the subglottis.
0:27
Therefore we will use the staging for
0:29
glottic laryngeal squamous cell carcinoma.
0:33
Unlike pharyngeal squamous cell carcinoma,
0:36
the dimensions of the tumor are less important, but should
0:39
nevertheless be measured and quoted in the report.
0:43
Key features which help us stage this tumor are
0:47
the status of soft tissue planes in the supraglottis
0:52
and the status of the thyroid cartilages.
0:56
So in this case, at the level of the vocal cords,
1:03
we can no longer distinguish normal arytenoid cartilages.
1:07
So that's the first thing that I can see here.
1:10
There should be two normal arytenoid
1:13
cartilages here; they are not present.
1:15
At the same level, there is invasion of both the
1:19
inner and outer cortex of the thyroid cartilages.
1:24
This is all abnormal soft tissue tumor,
1:28
all abnormal laryngeal malignancy.
1:32
And indeed, it has taken over
1:35
the arytenoid cartilages as well.
1:39
So based on that knowledge, we already know
1:42
that this tumor is moderately advanced.
1:45
And the reason we know is that it has invaded
1:48
the outer cortex of the thyroid cartilage.
1:51
Possibly also invaded the strap musculature
1:55
overlying that in the anterior neck.
1:58
The only decision that remains for T staging
2:01
is, is it very advanced local disease?
2:04
Does it invade the prevertebral space?
2:07
Does it encase the carotid artery?
2:08
Does it invade the mediastinum?
2:10
It does none of those things,
2:12
so therefore this tumor is a T4A tumor.
2:17
You need to also mention that it is moderately
2:21
to markedly narrowing the airway at this level.
2:24
So there is the potential for an acute emergency.
2:27
And also it is a primarily right-sided
2:32
tumor, but well and truly crossing the
2:34
midline with marked left-sided involvement.
2:38
Whilst the tumor is closely abutting the cricoid cartilage
2:42
inferiorly, it is difficult to say whether it is
2:46
eroded, because we can actually see thyroid
2:50
cartilage on the T2 which is intact, but there is
2:55
some evidence of infiltration on the T1-weighted
2:58
imaging which is likely not partial voluming.
3:01
So, definitely involving thyroid and arytenoid
3:04
cartilages, possibly involving cricoid cartilage as well.
3:09
In our next vignette, we will discuss
3:11
the N staging of this tumor.
Report
Description
Faculty
Sidney Levy, PhD, MBBS
Radiologist and Nuclear Medicine Specialist
I-MED
Tags
Neuroradiology
Neuro
Neoplastic
MRI
Larynx
Head and Neck
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