MRI Orbits, Face, and Neck Without IV Contrast There is no relevant literature to support the use of MRI orbits, face, and neck without IV contrast in the initial staging of suspected or diagnosed cancer of the paranasal sinuses or nasal cavity. Combined pre- and postcontrast imaging provides the best opportunity to correctly identify and delineate the primary site, distinguishing it from the surrounding normal soft tissues. The absence of IV contrast limits the ability to accurately delineate margin and the soft tissue extent of the tumor, which is a key component in the T staging of disease and essential for treatment planning. However, noncontrast MRI sequences are routinely used to identify the primary tumor and to define tumor extent, in particular marrow involvement, and are used in nodal staging. Radiography Paranasal Sinuses There is no relevant literature to support the use of radiography of the paranasal sinuses in the initial staging of suspected or diagnosed cancer of the paranasal sinuses or nasal cavity. US Neck US can be a useful adjunct to cross-sectional imaging, in particular for nodal staging of head and neck cancer. Coupled with fine-needle aspiration and/or core-needle biopsy, nodal evaluation with US is a reliable tool and correlates well with staging, following neck dissection [62]. A range of sensitivities and specificities for detection of nodal disease are found in the literature, likely reflecting the highly operator-dependent nature of this technique. US alone has been shown to very sensitive (77.8%-96.8%) and specific (68.75%-97%) in detecting cervical nodal metastases [47,63-65]. Variant 4: Suspected or diagnosed cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Initial staging. The salivary glands are classified into major and minor. The major salivary glands are paired bilateral parotid, submandibular, and sublingual glands.
Staging and Post Therapy Assessment of Head and Neck Cancer. MRI Orbits, Face, and Neck Without IV Contrast There is no relevant literature to support the use of MRI orbits, face, and neck without IV contrast in the initial staging of suspected or diagnosed cancer of the paranasal sinuses or nasal cavity. Combined pre- and postcontrast imaging provides the best opportunity to correctly identify and delineate the primary site, distinguishing it from the surrounding normal soft tissues. The absence of IV contrast limits the ability to accurately delineate margin and the soft tissue extent of the tumor, which is a key component in the T staging of disease and essential for treatment planning. However, noncontrast MRI sequences are routinely used to identify the primary tumor and to define tumor extent, in particular marrow involvement, and are used in nodal staging. Radiography Paranasal Sinuses There is no relevant literature to support the use of radiography of the paranasal sinuses in the initial staging of suspected or diagnosed cancer of the paranasal sinuses or nasal cavity. US Neck US can be a useful adjunct to cross-sectional imaging, in particular for nodal staging of head and neck cancer. Coupled with fine-needle aspiration and/or core-needle biopsy, nodal evaluation with US is a reliable tool and correlates well with staging, following neck dissection [62]. A range of sensitivities and specificities for detection of nodal disease are found in the literature, likely reflecting the highly operator-dependent nature of this technique. US alone has been shown to very sensitive (77.8%-96.8%) and specific (68.75%-97%) in detecting cervical nodal metastases [47,63-65]. Variant 4: Suspected or diagnosed cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Initial staging. The salivary glands are classified into major and minor. The major salivary glands are paired bilateral parotid, submandibular, and sublingual glands.