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U Baum

Publications and source records attributed to U Baum.

At least 19 recordsLinked to original sources
PubMed2003

Neoadjuvant treatment with weekly high-dose 5-Fluorouracil as 24-hour infusion, folinic acid and oxaliplatin in patients with primary resectable liver metastases of colorectal cancer.

PURPOSE: To evaluate the efficacy and safety of neoadjuvant treatment comprising weekly high-dose 5-fluorouracil (5-FU) as a 24-hour infusion, folinic acid (FA) and biweekly oxaliplatin (L-OHP), followed by metastatic resection in patients with primarily resectable liver metastases of colorectal cancer (CRC). PATIENTS AND METHODS: 20 patients with primarily resectable liver metastases of CRC were enrolled in a prospective phase II study. On an outpatient basis, the patients received a treatment regimen comprising biweekly 85 mg/m(2) L-OHP in the form of a 2-hour intravenous infusion and 500 mg/m(2) FA as a 1- to 2-hour intravenous infusion, followed by 2,600 mg/m(2 ) 5-FU administered as a 24-hour intravenous infusion once weekly. A single treatment cycle comprised one infusion per week during a period of 6 weeks followed by a 2-week rest. Two cycles were administered, with a third being added when the treatment was well tolerated. Thereafter, curative resection of the liver metastases was attempted, and the patients were followed up. RESULTS: After neoadjuvant therapy, 2 of the original 20 patients showed complete remission (CR; 10%) and 18 patients partial remission (PR; 90%). As the main symptom of toxicity, diarrhea (CTC toxicity grade 3-4) was observed in 6 patients (30%), followed by vomiting in 3 patients (15%). The curative resectability rate was 80% (16 of 20). In 9 of 18 patients (50%) undergoing surgical intervention, mild postoperative complications, mainly wound healing disturbances (n = 5), occurred. No postoperative mortality was observed. Over a median follow-up of 23 months (12-38) 6 of 16 curatively resected patients developed distant metastases and 1 patient a local pelvic recurrence. The 2-year disease-free survival rate was 52% and the 2-year cancer-related survival rate 80%. CONCLUSION: The neoadjuvant treatment with weekly high-dose 5-FU in the form of a 24-hour infusion combined with FA and L-OHP is very effective and well tolerated. Surgical morbidity does not appear to be increased by the neoadjuvant treatment.

Aged↗
PubMed2002

[CT and MRI of the petrous bone].

Diseases of the petrous bone should now be diagnosed by means of high-resolution multislice spiral computed tomography (MSCT) and/or magnetic resonance imaging (MRI). The first step in the process of diagnosis, however, must be conventional X-ray photographs (according to Schüller, Mayer, Stenvers) for screening purposes, because of the high cost of the other procedures mentioned. Because of the excellent imaging of bone structures with MSCT, this technique is especially suitable for the diagnosis both of acquired pathologies and of congenital abnormalities of the external auditory meatus, the middle ear and the mastoid, of trauma-induced pathologies of the entire petrous bone, and of osteogenic diseases. MRI is the method of choice for examination of the labyrinthine system, the interior auditory meatus and the cerebellopontine angle because it gives much the best depiction of soft tissue. Sometimes when questions remain unsolved after computed tomography (CT) examination of the middle ear MRI can be applied to complement CT, and it can yield additional information. Lesions affecting the apex of the petrous pyramid should be examined by MRI. High-resolution CT through the bone window and thin-layer MRI are both components of the presurgical diagnosis before cochlear implant (CI) surgery. For postoperative monitoring a conventional transorbital X-ray of the petrous bone is sufficient; CT is indicated only in complicated cases, and MRI is absolutely contraindicated after CI.

Artifacts↗
PubMed2002

[Visualization of coronary arteries in CT as assessed by a new 16 slice technology and reduced gantry rotation time: first experiences].

PURPOSE: First evaluation of image quality of a new 16-slice multidetector-row computed tomography (MDCT) for the assessment of coronary artery disease and lesion detection of the coronary arteries. MATERIALS AND METHODS: On a newly developed 16-slice CT scanner (SOMATOM Sensation 16, Siemens, Forchheim, Germany) a calcium score as well as a contrast-enhanced CT angiography (CTA) were performed on 4 patients with retrospective ECG-gating and a gantry rotation time of 420 ms to exclude or follow-up coronary heart disease. CTA was performed after injecting 120 ml contrast media intravenously. After medication with a ss-Blocker, the heart rate was between 55 and 67 bpm. RESULTS: The scan time for calcium score was 12 s, for CTA 18 s (scan range 15 and 12 cm, respectively). Volume score was between 0 and 256.4. In the CT angiography the entire coronary tree could be visualized in all patients up to the very distal subsegmental branches. In two patients a complete occlusion of the RCA and the LAD were depicted, respectively. In one of these patients, a large aneurysm of the left anterior ventricular wall was also delineated. CONCLUSION: Considering our first experiences with the new 16-slice technology, an excellent visualization of the entire coronary tree including the very distal and side branches due to substantially increased spatial resolution seems to be achievable. In these patients the acquired image quality raises the hope for improved, non-invasive cardiac diagnostics. In larger studies, the clinical impact of this new technology needs to be further investigated.

Aged↗
PubMed2002

[MR imaging of pancreatic lesions with Mn-DPDP. A histopathologic correlation].

PURPOSE: To examine the diagnostic accuracy of pancreatic lesions using mangafodipir-trisodium (Mn-DPDP) enhanced MR imaging. The imaging results were correlated with the histopathological results. MATERIAL AND METHODS: 40 patients with suspicion of pancreatic carcinoma were examined with MRI before and after i. v. administration of Mn-DPDP (Philips Gyroscan ACS NT 1.5 T, phased array body-coil: TSE T 2 with and without SPIR, TR 2000 ms, TE 120ms; FFE T 1 breathhold, TR 115 ms, TE 4.6 ms; MRCP, TR 6000 ms, TE 1200 ms; Teslascan i. v. 5 micromol Mn/kg; FFE T 1 breathhold SPIR, TR 140 ms, TE 4,6 ms). Two observers evaluated in consensus the number and characteristics of focal pancreatic lesions. The MR findings were correlated with histopathological findings retrospectively. RESULTS: The following lesions were found: adenocarcinoma (19), pancreatitis (8), adenocarcinoma within pancreatitis (3), insulinoma (2), hematoma (1), papillitis stenosans (1), signet ring cell carcinoma (1), metastasis of rectal carcinoma (1), papillary mesothelioma (1). In three patients there was no pathological finding. Mn-DPDP enhanced MRI showed a sensitivity of 100 % and a specificity of 56 %. CONCLUSION: Mn-DPDP enhanced MRI in conjunction with MRCP showed a high sensitivity for the detection of pancreatic lesions. However, the specificity is low, thus recommending Mn-DPDP enhanced MRI only as a complementary imaging method.

Ampulla of Vater↗
PubMed2002

[CT-angiography of the carotid artery: First results with a novel 16-slice-spiral-CT scanner].

PURPOSE: To evaluate a novel multislice CT system (16-slice-spiral-CT scanner) for the diagnosis of carotid artery stenosis. MATERIAL AND METHODS: Five patients with symptomatic atherosclerotic disease of the carotid arteries were examined with a 16- slice-spiral-CT scanner. Collimation was 16 x 0.75 mm, table speed 36 mm/s (pitch of 1.5), rotation time 0.5 s, tube current was 160 eff.mAs at 120 kV. 60 ml of contrast material were injected with a power injector followed by a saline flush. The start delay was measured with test bolus method (20 ml CM). Interactive multiplanar reformation (iMPR) and thin slab MIP as well as volume rendering were used for image evaluation and presentation. RESULTS: Scan time was 9 s for a range of 300 mm. This allowed imaging the whole length of the carotid artery (aortic arch to circle of Willis) in a true arterial phase. Pulsation artefacts did not impair the evaluation of the vessels at the level of the aortic arch. Overall image quality of both "source images" and 3D-reconstructions was excellent, due to a reduced voxel size of 0.03 mm (3). Image evaluation and postprocessing (iMPR, MIP) was done within 15 min. iMPR was highly accurate for demonstrating plaque morphology and determining the percentage of the stenosis. CONCLUSION: For the first time, true arterial phase images of the entire carotid artery with high spatial resolution could be acquired using a 16-slice-spiral-CT scanner. This method offers the potential to replace catheter angiography in the evaluation of carotid artery stenosis.

Blood Flow Velocity↗
PubMed2002

[Influence of heart rate on image quality and detection of coronary stenoses with multislice spiral CT].

Multi-slice spiral CT (MSCT) permits the detection of coronary stenoses. We investigated the influence of the patient's heart rate (HR) during the scan on stenosis detection and the presence of motion artifacts. In 100 patients MSCT was performed and retrospectively ECG-gated cross-sectional images were reconstructed. 115 of 400 coronary arteries (29%) were unevaluable due to motion artifacts (84/115) or other reasons (31/115). In evaluable arteries, sensitivity was 91% (51/56 high grade stenoses detected), specificity was 89%. With increasing HR, the number of unevaluable arteries increased and overall sensitivity for stenosis detection decreased from 62% (HR < or = 70 bpm) to 33% (HR > 70 bpm). MSCT permits detection of coronary stenoses, but evaluability and accuracy decrease with increasing HR.

Aged↗
PubMed2001

Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography.

BACKGROUND: Multislice spiral computed tomography (MSCT) with retrospectively ECG-gated image reconstruction permits coronary artery visualization. We investigated the method's ability to identify high-grade coronary artery stenoses and occlusions. METHODS AND RESULTS: A total of 64 consecutive patients were studied by MSCT (4x1 mm cross-sections, 500-ms rotation, table feed 1.5 mm/rotation, intravenous contrast agent, retrospectively ECG-gated image reconstruction). All coronary arteries and side branches with a luminal diameter >/=2.0 mm were assessed concerning evaluability and the presence of high-grade stenoses (>70% diameter stenosis) or occlusions. Results were compared with quantitative coronary angiography. Of 256 coronary arteries (left main, left anterior descending, left circumflex and right coronary artery, including their respective side branches), 174 could be evaluated (68%). In 19 patients (30%), all arteries were evaluable. Artifacts caused by coronary motion were the most frequent reason for unevaluable arteries. Overall, 32 of 58 high-grade stenoses and occlusions were detected by MSCT (58%). In evaluable arteries, 32 of 35 lesions were detected, and the absence of stenosis was correctly identified in 117 of 139 arteries (sensitivity, 91%; specificity, 84%). If analysis was extended to all stenoses with >50% diameter reduction, sensitivity was 85% (40 of 47) and specificity was 76% (96 of 127). CONCLUSIONS: MSCT with retrospective ECG gating permits the detection of coronary artery stenoses with high accuracy if image quality is sufficient, but its clinical use may presently be limited due to degraded image quality in a substantial number of cases, mainly due to rapid coronary motion.

Aged↗
PubMed2001

Impact of surgery on survival in palliative patients with metastatic colorectal cancer after first line treatment with weekly 24-hour infusion of high-dose 5-fluorouracil and folinic acid.

BACKGROUND: In palliative first-line treatment of colorectal cancer, the secondary resection of distant metastases after downstaging has constantly gained in importance. The objective of this prospective study was to examine the tumor response rate, the toxicity, the median survival time and the prognostic impact of metastatic resection after downstaging of consecutively enrolled patients with primary nonresectable colorectal cancer treated with once weekly 24-hour (24-h) infusion of high-dose 5-fluorouracil (5-FU) and folinic acid. PATIENTS AND METHODS: Between January 1995 and July 1997, 53 consecutive patients with primary nonresectable metastases were recruited for a prospective phase II study. The patients received in out-patient care 500 mg/m2 folinic acid in the form of a 1-2-hour infusion followed by 2600 mg/m2 5-FU administered as a 24-h infusion once weekly. One treatment cycle comprised six weekly infusions followed by a two week rest. Three cycles were administered, and in the event of complete remission (CR) or partial remission (PR) and good tolerability, a fourth cycle was undertaken. Thereafter, the possibility of performing a curative metastatic resection was investigated. RESULTS: Of the 53 patients treated, 7 showed a CR (13%), 15 patients a PR (28%), 26 patients stable disease (SD) (49%), and 5 patients progressive disease (PD) (10%). As the main symptom of toxicity, diarrhea (CTC grade 3 + 4) was observed in 11 patients (21%), followed by leucocytopenia (CTC grade 3 + 4) in 2 patients (4%), and the hand-foot syndrome in 1 patient (2%). The median survival time was 17 months with a median follow-up of 41 months (range: 28-59 months). In 9 patients (17%), a secondary metastatic resection was considered; in 6 patients (11%) curative resection was performed, and 4 patients (8%) showed no evidence of disease for at least three years. CONCLUSION: In this phase II study, we have been able to show prospectively that, after downstaging by palliative treatment using a weekly 24-h infusion of high-dose 5-FU and folinic acid, secondary curative metastatic resection was technically feasible in 11% of the patients. For some of these patients, long-term survival is therefore possible. Secondary metastatic resection should be carried out in close interdisciplinary cooperation, and should be further investigated in prospective phase III studies.

Aged↗
PubMed2001

[Dose reduction in spiral-CT: detection of pulmonary coin lesions with and without anatomically adjusted modulation of tube current].

PURPOSE: To investigate the potential of projection angle-dependent anatomical adaptation of tube current to reduce dose in spiral CT examinations of the thorax without loss in detectability of pulmonary nodules and image quality. PATIENTS AND METHODS: Dose can be reduced for non-circular patient cross-sections without an increase in noise if the tube current is reduced at those angular positions where the patient diameter and, consequently, attenuation are small. The examinations were dose with SOMATOM Plus 4 (Siemens AG). CT projection data were analysed to determine the optimum tube current for each projection angle in real time. We compared image quality, done, and detection rates of pulmonary nodules for thoracic spiral CT examinations with and without online anatomically adapted tube current control in a group of 38 patients. Three radiologists counted all intrapulmonary nodules in consensus separated in three different groups (< 5 mm, 5-10 mm, > 10 mm). Image quality was evaluated in a scale from 1-3 (1 = very good, 2 = good, 3 = worse). RESULTS: On average, the dose was reduced by 21% (15-34%). With a constant tube current, 704 pulmonary nodules were detected, with tube current modulation 707 pulmonary nodules. For three patients we saw more pulmonary nodules (five) with tube current modulation, for two patients we saw less pulmonary nodules (two). In a direct comparison, the missed intrapulmonary nodules were also detected in the respective method. Thus, the detection rate of intrapulmonary nodules was uninfluenced. In general, no deterioration of image quality was observed. CONCLUSION: On average, 21% dose reduction was achieved by an anatomically adapted tube current modulation in spiral CT examinations of the thorax without a loss in detectability of pulmonary nodules and image quality. This method is an important contribution to dose reduction in spiral CT.

Diagnosis, Differential↗
PubMed2001

[Neuritis of the optic nerve after vaccinations against hepatitis A, hepatitis B and yellow fever].

BACKGROUND: Vaccinations are preventive measures against serious infections. In relation to the number of vaccinations per year, the incidence of severe complications is extremely low. PATIENT: Two weeks after vaccinations against hepatitis A, hepatitis B and yellow fever in preparation for a trip to Africa a 21-year-old woman experienced an acute and irreversible loss of vision to 0,05 and nasal visual field defect in the left eye. Whereas vision acuity did not recover the scotoma disappeared within 6 weeks. Cerebrospinal fluid showed a lymphocytic pleocytosis. Oligoglonale bands were absent. Pathological parameters were not presented in the serum. The MRI showed a hyperintense thickening of optic nerve,as well as a hyperintense focus in right temporal side using the T(2)W-Sequence. CONCLUSION: Only few cases have been reported with neurological complications, such as encephalitis, following vaccinations each of the above mentioned. As no other causes for the inflammation were found, the optic nerve involvement must have been caused by the vaccination. Which of the three vaccinations caused encephalitis can not be classified.

Adult↗
PubMed2000

Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT.

BACKGROUND: We investigated the applicability and image quality of contrast-enhanced coronary artery visualization by multislice spiral CT using retrospective ECG gating. METHODS AND RESULTS: Twenty-five patients in sinus rhythm (significant coronary artery stenoses ruled out by invasive angiography) were studied with a multislice spiral CT (Siemens SOMATOM Volume Zoom). In inspiration (mean breath-hold, 37 seconds), a volume data set of the heart was acquired (intravenous contrast agent; 4 x 1-mm slice thickness; 500-ms rotation; table feed, 1.5 mm/360 degrees ). Simultaneous recording of the ECG permitted retrospective reconstruction of contiguous cross sections in intervals of 1 mm at any desired interval of the cardiac cycle. The mean duration of the image reconstruction window was 185 ms. Next to 3-dimensional reconstructions of the heart and coronary arteries, multiplanar reconstructions were rendered to determine the visualized length of the coronary arteries, the contrast-to-noise ratio, and the correlation of coronary artery diameters to quantitative coronary angiography. CONCLUSIONS: The coronary arteries could be visualized over long segments (left main, 9+/-4 mm; left anterior descending, 112+/-34 mm; left circumflex, 80+/-29 mm; right coronary artery, 116+/-33 mm). On average, 78+/-16% of these distances were visualized free of motion artifacts. The mean contrast-to-noise ratio was 9.3+/-3.3. Coronary artery diameters in multislice spiral CT showed close correlation to quantitative coronary angiography (CT, 3.3+/-1.0 mm; angiography, 3. 2+/-0.9 mm; mean difference, 0.38 mm; r=0.86). Contrast-enhanced multislice spiral CT permits visualization of the coronary artery lumen. Further studies are necessary to determine whether image quality is sufficient to reliably detect coronary artery stenoses.

Adult↗
PubMed2000

Adjuvant and neoadjuvant radiochemotherapy in ductal pancreatic carcinoma.

BACKGROUND: Ductal pancreatic carcinoma ranks third among malignancies of the gastrointestinal tract and its incidence is rising. Today, patients with this disease still have fatal prognosis necessitating efforts towards more effective treatment. MATERIAL AND METHODS: This report provides a review of adjuvant and neoadjuvant radiotherapy in pancreatic carcinoma without distant metastasis. Particular respect is given to prospective, randomized trials. They are analyzed according to clinical staging: 1. In resectable tumors adjuvant, neoadjuvant or intraoperative radiotherapy is performed. 2. Radiotherapy in neoadjuvant intention is an approach for downstaging to achieve resectability in initially irresectable tumors. RESULTS: The widespread use of new techniques such as supervoltage irradiation, computer based 3-D-planning, interventional therapy and combination of different therapeutic modalities induced a great number of studies. When concomitant chemotherapy was added to radiotherapy, results became significantly better compared to exclusive radiotherapy. It is shown that patients with operable tumors will have better survival rates and lower risk of relapse, if radiochemotherapy is added to surgery. Patients with irresectable tumors possible can be downstaged and be brought to resection nevertheless. CONCLUSIONS: Simultaneous radiochemotherapy with 5-FU and mitomycin C can be performed without elevated risk of acute side effects of higher degree. This approach may be indicated in the case of adjuvant situations in patients free of distant metastases. Neoadjuvant simultaneous radiochemotherapy should only be performed as a part of a clinical trial.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

Dose reduction in computed tomography by attenuation-based on-line modulation of tube current: evaluation of six anatomical regions.

This study investigated the potential of attenuation-based on-line modulation of tube current to reduce the dose of computed tomography (in milliamperes) without loss in image quality. The dose can be reduced for non-circular patient cross-sections by reducing the tube current at the angular positions at which the diameter through the patient diameter is smallest. We investigated a new technical approach with attenuation-based on-line modulation of tube current. Computed tomographic projection data were analyzed to determine the optimal milliampere values for each projection angle in real time, instead of performing prior measurements with localizer radiographs. We compared image quality, noise pattern, and dose for standard scans and for scans with attenuation-based on-line modulation of tube current in a group of 30 radiation therapy patients. Six different anatomical regions were examined: head, shoulder, thorax, abdomen, pelvis, and extremities (knee). Image quality was evaluated by four radiologists in a blinded fashion. We found the dose to be reduced typically by 15-50 %. In general, no deterioration in image quality was observed. Thus the dose in computed tomography be reduced substantially by technical measures without sacrificing image quality. Attenuation-based on-line modulation of tube current is an efficient and practical means for this.

Humans↗
PubMed2000

Head and neck tumors: imaging recurrent tumor and post-therapeutic changes with CT and MRI.

OBJECTIVE: To evaluate criteria for detection of tumor recurrence and post-treatment changes in patients with head and neck malignancies in computed tomography (CT) and magnetic resonance imaging (MRI). METHODS AND MATERIALS: Thirty-nine patients with head and neck carcinoma receiving radiochemotherapy were examined before, during and after therapy with MRI. Changes in signal intensity were correlated to histology or clinical course. Three hundred and thirty-one patients with head and neck malignancies were examined with CT after therapy. CT diagnoses were correlated with histology or clinical course. RESULTS: Main criteria for recurrent/residual tumor in MRI was infiltrative mass with high signal intensity in T2-weighted images and enhancement after Gd-DTPA in T1-weighted images. Radiation-induced changes led to false positive diagnosis in 46% in the interval up to 3 months after therapy and in 58% in the interval 3-6 months after therapy. The combination of a circumscribed, infiltrative mass with contrast enhancement in CT had a sensitivity of 86% and a specificity of 80%. CONCLUSION: CT could accurately demonstrate postoperative changes and tumor recurrence. MRI had advantages in differentiation of tumor and scar, but edema after radiation therapy can spoil diagnosis.

Combined Modality Therapy↗
PubMed2000

Imaging of head and neck tumors--methods: CT, spiral-CT, multislice-spiral-CT.

Spiral-CT is standard for imaging neck tumors. In correspondence with other groups we routinely use spiral-CT with thin slices (3 mm), a pitch of 1.3-1.5 and an overlapping reconstruction increment (2-3 mm). In patients with dental fillings a short additional spiral parallel to the corpus of the mandible reduces artifacts behind the dental arches and improves the diagnostic value of CT. For the assessment of the base of the skull, the orbital floor, the palate and paranasal sinuses an additional examination in the coronal plane is helpful. Secondary coronal reconstructions of axial scans are helpful in the evaluation of the crossing of the midline by small tumors of the tongue base or palate. For an optimal vascular or tissue contrast a sufficient volume of contrast medium and a start delay greater than 70-80 s are necessary. In our opinion the best results can be achieved with a volume of 150 ml, a flow of 2.5 ml/s and a start delay of 80 s. Dynamic enhanced CT is only necessary in some special cases. There is clear indication for dynamic enhanced CT where a glomus tumor is suspected. Additional functional CT imaging during i-phonation and/or Valsalva's maneuver are of great importance to prove vocal cords mobility. Therefore, imaging during i-phonation is an elemental part of every thorough examination of the hypopharynx and larynx region. Multislice-spiral-CT allows almost isotropic imaging of the head and neck region and improves the assessment of tumor spread and lymph node metastases in arbitrary oblique planes. Thin structures (the base of the skull, the orbital floor, the hard palate) as well as the floor of the mouth can be evaluated sufficiently with multiplanar reformations. Usually, additional coronal scanning is not necessary with multislice-spiral-CT. Multislice-spiral-CT is especially advantageous in defining the critical relationships of tumor and lymph node metastases and for functional imaging of the hypopharynx and larynx not only in the transverse plane but also in the coronal plane.

Glomus Tumor↗
PubMed2000

Paranasal sinuses and nasopharynx CT and MRI.

Neoplastic disease of the nose, paranasal sinuses, the nasopharynx and the parapharyngeal space requires thorough assessment of location and extent in order to plan appropriate treatment. CT allows the deep soft tissue planes to be evaluated and provides a complement to the physical examination. It is especially helpful in regions involving thin bony structures (paranasal sinuses, orbita); here CT performs better than MRI. MRI possesses many advantages over other imaging modalities caused by its excellent tissue contrast. In evaluating regions involving predominantly soft tissue structures (ec nasopharynx and parapharyngeal space) MRI is superior to CT. The possibility to obtain strictly consecutive volume data sets with spiral CT or 3D MRI offer excellent perspectives to visualize the data via 2D or 3D postprocessing. Because head and neck tumors reside in a complex area, having a 3D model of the anatomical features may assist in the delineation of pathology. Data sets may be transferred directly into computer systems and thus be used in computer assisted surgery.

Angiofibroma↗
PubMed2000

Oropharynx, oral cavity, floor of the mouth: CT and MRI.

Pretherapeutic staging of tumors of the oropharynx, the oral cavity and the floor of the mouth is important and should be thorough and exact to ensure appropriate therapy. Particularly important is the assessment of infiltration of deeper compartments and the topographic relationship of tumor to vascular structures (lingual artery and vein, hypoglossal nerve), or the presence of spread of the tumor across the midline. As spread of tumor may occur to a large degree underneath normal appearing mucosa, clinical assessment of the true tumor extent is difficult. In the last 20 years computed tomography (CT) has proved its value as a supplementary non-invasive method and established its role in modern diagnostic evaluation. Magnetic resonance imaging (MRI) is an non-invasive scanning method that offers excellent tissue contrast. Ultrasonography (US) is of secondary importance, but provides useful guidance due to its wide availability and its easy use. This paper aims to depict the possibilities of modern CT and MRI to provide 'one-stop-shopping' information to the clinician as a basis for the right therapeutic approach and correct estimation of the individual patient's prognosis. A clear problem oriented imaging strategy with standardized diagnostic criteria will lead to a cost effective evaluation.

Contrast Media↗