Customized chairside single visit Oral stent to stabilize the mandible while providing enhanced delineation of neighboring hard and soft tissue enabling timely accurate diagnostic staging of oral and oro-pharyngeal cancer.

1301 Objectives FDG-PET/CT imaging determines disease staging and subsequent radiation treatment planning in HNSCC. Due to the recumbent position of the patient, the laxity of oral soft tissue, the size and location of the primary tongue and the location of the oral lesion may collectively result in a clear demarcation of tumor uptake from its neighboring tissue such as mandible, soft palate, tonsil, floor of mouth etc. This educational exhibit demonstrates the chairside fabrication of a simple single visit patient-customized oral stent to allow for the effective separation of tumor from surrounding structures, enabling time saving and accurate diagnostic staging and treatment planning of the patient. Methods Method: 3 case reports document the use of an oral stent, fabricated at the time of imaging visit, for effective diagnostic staging of oral squamous cell carcinoma (SCC). The stent utilizes a solid thermoplastic nontoxic, hypoallergenic material that softens in hot water into translucent moldable material that is easily adapted intraorally to conform to the patient’s oral tissues and to displace the tongue from the adjacent hard tissues (Hydroplastic® TAK Systems, Waltham MA). On cooling, the stent material hardens. Additional material can be added to the stent as needed to achieve the desired configuration. The patient wears the stent during diagnostic PET/CT imaging. Brief description of Cases: 1. 51 year old female with T2N0M0 squamous cell carcinoma of left lateral tongue 2. 53 year old male with T4N3M0 squamous cell carcinoma of left oral tongue 3. 77 year old male with T2N1M0 squamous cell carcinoma of left oral tongue Results The enhanced separation of tumor tissue from its neighboring oral structures such as gingival tissue overlying the mandible which is adjacent to the tumor tissue along the ventrolateral tongue. The case reports verify the effectiveness of this single visit oral stent fabrication technique to augment the demarcated of the tumor uptake from the adjacent oral tissues. Conclusions Local invasion of tissues such as bone, floor of mouth and lip/cheek tissue define tumor staging and hence important to determine unambiguously which tissue has the uptake. Accurate diagnostic staging of oral and oro-pharyngeal cancer may be enhanced by utilizing the customized oral stent. This educational exhibit illustrates enhanced patient care through interdisciplinary management between the departments of Radiology, Nuclear Medicine and Dentistry. In addition, these reports verify that the material for such intraoral stents does not cause distortion or scatter of tracer uptake.