Assessment of Head and Neck Cancer MRI Head Without and With IV Contrast There is no relevant literature to support the use of MRI head without and with IV contrast in the initial staging of suspected or diagnosed NPC or EBV-associated unknown primary of the head and neck. The coverage of an MRI of the head and MRI sequences tailored for assessment of the brain may be insufficient to completely evaluate the primary site in the nasopharynx and will not include regional nodal staging. MRI head without and with IV contrast may be used to further delineate advanced intracranial extension of disease if it is suspected based on clinical examination or other imaging modalities. MRI Head Without IV Contrast There is no relevant literature to support the use of MRI head without IV contrast in the initial staging of suspected or diagnosed NPC or EBV-associated unknown primary of the head and neck. MRI Orbits, Face, and Neck With IV Contrast There is no relevant literature to support the use of MRI of the orbits, face, and neck with IV contrast in the initial staging of suspected or diagnosed NPC or EBV-associated unknown primary of the head and neck. MRI Orbits, Face, and Neck Without and With IV Contrast MRI of the orbits, face, and neck without and with IV contrast has superior soft tissue contrast resolution and with this an improved ability to delineate the soft tissue extent of the tumor at the primary site. MRI provides high sensitivity and specificity for correctly identifying the primary site [81,82], and the superior soft tissue contrast resolution allows for accurate evaluation of local extent of disease, including identification of subtle skull base marrow involvement, intracranial extension, and detection of perineural spread of disease [90,91]. Furthermore, MRI has been found to correctly identify the site of the tumor in endoscopically occult disease [81,92].
Staging and Post Therapy Assessment of Head and Neck Cancer. Assessment of Head and Neck Cancer MRI Head Without and With IV Contrast There is no relevant literature to support the use of MRI head without and with IV contrast in the initial staging of suspected or diagnosed NPC or EBV-associated unknown primary of the head and neck. The coverage of an MRI of the head and MRI sequences tailored for assessment of the brain may be insufficient to completely evaluate the primary site in the nasopharynx and will not include regional nodal staging. MRI head without and with IV contrast may be used to further delineate advanced intracranial extension of disease if it is suspected based on clinical examination or other imaging modalities. MRI Head Without IV Contrast There is no relevant literature to support the use of MRI head without IV contrast in the initial staging of suspected or diagnosed NPC or EBV-associated unknown primary of the head and neck. MRI Orbits, Face, and Neck With IV Contrast There is no relevant literature to support the use of MRI of the orbits, face, and neck with IV contrast in the initial staging of suspected or diagnosed NPC or EBV-associated unknown primary of the head and neck. MRI Orbits, Face, and Neck Without and With IV Contrast MRI of the orbits, face, and neck without and with IV contrast has superior soft tissue contrast resolution and with this an improved ability to delineate the soft tissue extent of the tumor at the primary site. MRI provides high sensitivity and specificity for correctly identifying the primary site [81,82], and the superior soft tissue contrast resolution allows for accurate evaluation of local extent of disease, including identification of subtle skull base marrow involvement, intracranial extension, and detection of perineural spread of disease [90,91]. Furthermore, MRI has been found to correctly identify the site of the tumor in endoscopically occult disease [81,92].