There is a paucity of relevant supportive literature specifically comparing the diagnostic performance of CT chest with IV contrast and CT chest without IV contrast. CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast in the evaluation of treated cancer of the paranasal sinuses or nasal cavity. Assessment of Head and Neck Cancer CT Chest Without IV Contrast CT chest without IV contrast can accurately identify pulmonary metastasis and be used to detect thoracic nodal and skeletal metastases to the ribs or vertebrae. Patients with recurrent head and neck squamous cell carcinoma are significantly more likely to have pulmonary metastatic disease [21,120]. Development of lung metastases is also increased in advanced stage disease [15]. CT chest confers a superior spatial localization and contrast resolution compared to radiography, allowing for the improved detection of small pulmonary nodules [15]. The use of screening CT chest in patients treated with definitive therapy have been shown to detect metastatic disease that was successfully treated with salvage therapy [121]. The rates of detection of pulmonary metastatic disease in the setting of recurrent disease for chest CT is similar to that of FDG-PET/CT [122]. The use of IV contrast may improve detection of mediastinal and hilar adenopathy, distinguishing nodes from mediastinal vessels and aiding in the delineation of the soft tissue extension of the skeletal metastatic disease. Noncontrast CT chest may be considered as an alternative and is part of routine clinical practice, although there is paucity of relevant supportive literature evaluating the use of CT chest without IV contrast. CT Head With IV Contrast There is no relevant literature to support the use of CT of the head with IV contrast in the evaluation of suspected or known recurrence of treated cancer of the paranasal sinuses or nasal cavity.
Staging and Post Therapy Assessment of Head and Neck Cancer. There is a paucity of relevant supportive literature specifically comparing the diagnostic performance of CT chest with IV contrast and CT chest without IV contrast. CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast in the evaluation of treated cancer of the paranasal sinuses or nasal cavity. Assessment of Head and Neck Cancer CT Chest Without IV Contrast CT chest without IV contrast can accurately identify pulmonary metastasis and be used to detect thoracic nodal and skeletal metastases to the ribs or vertebrae. Patients with recurrent head and neck squamous cell carcinoma are significantly more likely to have pulmonary metastatic disease [21,120]. Development of lung metastases is also increased in advanced stage disease [15]. CT chest confers a superior spatial localization and contrast resolution compared to radiography, allowing for the improved detection of small pulmonary nodules [15]. The use of screening CT chest in patients treated with definitive therapy have been shown to detect metastatic disease that was successfully treated with salvage therapy [121]. The rates of detection of pulmonary metastatic disease in the setting of recurrent disease for chest CT is similar to that of FDG-PET/CT [122]. The use of IV contrast may improve detection of mediastinal and hilar adenopathy, distinguishing nodes from mediastinal vessels and aiding in the delineation of the soft tissue extension of the skeletal metastatic disease. Noncontrast CT chest may be considered as an alternative and is part of routine clinical practice, although there is paucity of relevant supportive literature evaluating the use of CT chest without IV contrast. CT Head With IV Contrast There is no relevant literature to support the use of CT of the head with IV contrast in the evaluation of suspected or known recurrence of treated cancer of the paranasal sinuses or nasal cavity.