Assessment of Head and Neck Cancer sufficient coverage for the anatomic evaluation of the primary site. However, CT maxillofacial will typically not include evaluation of the neck and would therefore be inadequate for the staging of regional lymphadenopathy. CT Maxillofacial Without and With IV Contrast There is no relevant literature to support the use of CT maxillofacial without and with IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT Maxillofacial Without IV Contrast There is no relevant literature to support the use of CT maxillofacial without IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT Neck With IV Contrast Although protocols vary across institutions, for the purposes of this document, CT of the neck includes coverage from the top of the frontal sinuses down to the level of the aortic arch, with thin slices, multiplanar reformats, and both soft tissue and bony algorithms. CECT of the neck allows for the detection and localization of nasopharyngeal tumor, treatment response assessment, and regional nodal staging. The evaluation of the posttreatment neck is often complicated by significant treatment-related changes that can be difficult to distinguish from persistent disease after therapy or recurrence. MRI confers improved soft tissue contrast over CT and is generally the preferred imaging modality for evaluating NPC recurrence. CT imaging does allow for excellent delineation of osseous anatomy, including bony destruction that can be seen in the context of recurrence or as a complication of treatment such as in osteoradionecrosis [144]. CT is also used to monitor treatment changes and assess for treatment complications such as infection. Contrast enhancement is imperative in order to correctly identify and delineate recurrence, distinguishing it from treatment changes.
Staging and Post Therapy Assessment of Head and Neck Cancer. Assessment of Head and Neck Cancer sufficient coverage for the anatomic evaluation of the primary site. However, CT maxillofacial will typically not include evaluation of the neck and would therefore be inadequate for the staging of regional lymphadenopathy. CT Maxillofacial Without and With IV Contrast There is no relevant literature to support the use of CT maxillofacial without and with IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT Maxillofacial Without IV Contrast There is no relevant literature to support the use of CT maxillofacial without IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT Neck With IV Contrast Although protocols vary across institutions, for the purposes of this document, CT of the neck includes coverage from the top of the frontal sinuses down to the level of the aortic arch, with thin slices, multiplanar reformats, and both soft tissue and bony algorithms. CECT of the neck allows for the detection and localization of nasopharyngeal tumor, treatment response assessment, and regional nodal staging. The evaluation of the posttreatment neck is often complicated by significant treatment-related changes that can be difficult to distinguish from persistent disease after therapy or recurrence. MRI confers improved soft tissue contrast over CT and is generally the preferred imaging modality for evaluating NPC recurrence. CT imaging does allow for excellent delineation of osseous anatomy, including bony destruction that can be seen in the context of recurrence or as a complication of treatment such as in osteoradionecrosis [144]. CT is also used to monitor treatment changes and assess for treatment complications such as infection. Contrast enhancement is imperative in order to correctly identify and delineate recurrence, distinguishing it from treatment changes.