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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.
0:00
Hello, everyone.
0:01
Sidney Levy here, continuing our discussion on the
0:03
diagnosis and staging of oral cavity malignancy.
0:09
In particular, we're focusing on this left
0:12
buccal mucosal squamous cell malignancy.
0:15
I have two images here of a
0:19
pre-contrast T1-weighted axial MR and
0:23
a post-contrast fat-suppressed T1 axial MR.
0:28
The lesion is a left buccal mucosal squamous
0:32
cell malignancy, and let's begin with T staging.
0:35
First thing I'd like to do is to measure the tumor.
0:39
We are looking for the maximal dimension, which may
0:42
either be in the axial, coronal, or sagittal projection.
0:46
In this case, it is in the axial projection.
0:48
The tumor comes out to just over three and
0:51
a half centimeters in maximal dimension.
0:54
The next measurement I'd like to make is depth of invasion.
0:57
Depth of invasion is a new criterion in the
1:00
staging of oral cavity squamous cell malignancy.
1:04
And you may consider it to be the thickness of the tumor.
1:07
That's an easy way to look at it.
1:10
Take the thickest part of the tumor, make a measurement.
1:13
This one happens to be 10 millimeters.
1:16
We then need to make a decision as to whether
1:19
it is invading any adjacent structures.
1:22
Such as, in particular, cortical bone of the maxilla or the
1:26
mandible, sinuses, or indeed the skin of the face as well.
1:32
This tumor does none of those things.
1:34
So based on the information I have, this tumor being
1:38
between 2 and 4 centimeters and 10 millimeters depth
1:42
of invasion, it is either a T2 tumor or a T3 tumor.
1:48
Now, I'd like to use this case to illustrate
1:52
an important principle when staging.
1:55
If a lesion is at the threshold of a boundary between two
2:00
stages, in this case, 10 mm depth of invasion is a boundary,
2:06
you should always err on the conservative side when staging
2:10
them for squamous cell malignancy in the head and neck.
2:14
So, we're going to call this a T2 tumor, with a depth
2:19
of invasion less than or equal to 10 millimeters,
2:22
and a tumor maximal dimension of between 2 and 4
2:27
centimeters, and without invasion of bone or skin.
2:31
In our next vignette, we will discuss
2:34
the N staging of this tumor.
T Staging of Buccal Mucosal Squamous Cell Malignancy
HIDEInteractive Transcript
0:00
Hello, everyone.
0:01
Sidney Levy here, continuing our discussion on the
0:03
diagnosis and staging of oral cavity malignancy.
0:09
In particular, we're focusing on this left
0:12
buccal mucosal squamous cell malignancy.
0:15
I have two images here of a
0:19
pre-contrast T1-weighted axial MR and
0:23
a post-contrast fat-suppressed T1 axial MR.
0:28
The lesion is a left buccal mucosal squamous
0:32
cell malignancy, and let's begin with T staging.
0:35
First thing I'd like to do is to measure the tumor.
0:39
We are looking for the maximal dimension, which may
0:42
either be in the axial, coronal, or sagittal projection.
0:46
In this case, it is in the axial projection.
0:48
The tumor comes out to just over three and
0:51
a half centimeters in maximal dimension.
0:54
The next measurement I'd like to make is depth of invasion.
0:57
Depth of invasion is a new criterion in the
1:00
staging of oral cavity squamous cell malignancy.
1:04
And you may consider it to be the thickness of the tumor.
1:07
That's an easy way to look at it.
1:10
Take the thickest part of the tumor, make a measurement.
1:13
This one happens to be 10 millimeters.
1:16
We then need to make a decision as to whether
1:19
it is invading any adjacent structures.
1:22
Such as, in particular, cortical bone of the maxilla or the
1:26
mandible, sinuses, or indeed the skin of the face as well.
1:32
This tumor does none of those things.
1:34
So based on the information I have, this tumor being
1:38
between 2 and 4 centimeters and 10 millimeters depth
1:42
of invasion, it is either a T2 tumor or a T3 tumor.
1:48
Now, I'd like to use this case to illustrate
1:52
an important principle when staging.
1:55
If a lesion is at the threshold of a boundary between two
2:00
stages, in this case, 10 mm depth of invasion is a boundary,
2:06
you should always err on the conservative side when staging
2:10
them for squamous cell malignancy in the head and neck.
2:14
So, we're going to call this a T2 tumor, with a depth
2:19
of invasion less than or equal to 10 millimeters,
2:22
and a tumor maximal dimension of between 2 and 4
2:27
centimeters, and without invasion of bone or skin.
2:31
In our next vignette, we will discuss
2:34
the N staging of this tumor.
Report
Description
Faculty
Sidney Levy, PhD, MBBS
Radiologist and Nuclear Medicine Specialist
I-MED
Tags
PET
Oral Cavity/Oropharynx
Nuclear Medicine
Neuroradiology
Neuro
Neoplastic
MRI
Head and Neck
CT
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