FDG-PET/CT has been shown to be effective in identifying subclinical recurrences in the posttreatment setting [132,133]. The presence of posttreatment inflammatory change decreases the specificity of findings on FDG-PET/CT [131,134,135]. For this reason, imaging with FDG-PET/CT should ideally occur no earlier than 12 weeks after completion of therapy [117,118] to allow for treatment effects to subside, although imaging as early as 8 weeks after therapy has been suggested [136]. Concurrent infection can similarly give false-positive findings. One study found that the combination of MRI with FDG-PET/CT has the best detection of locoregional recurrence [128]. FDG-PET/CT has been found to accurately diagnose distant metastatic disease in the posttreatment setting [19,119] and may be indicated in treated advanced stage disease because of the increased rate of distant metastases. FDG-PET/MRI Skull Base to Mid-Thigh FDG-PET/MRI is new imaging modality with a growing body of evidence demonstrating the feasibility of use for routine clinical imaging including in the response assessment and evaluation of recurrence following treatment of cancer of the head and neck with FDG-PET/MRI performing similar to FDG/PET CT [137,138]. MRA Neck With IV Contrast There is no relevant literature to support the use of MRA neck with IV contrast in the follow-up imaging or evaluation of suspected or known recurrence of treated cancer of the oral cavity, oropharynx, hypopharynx, larynx, or cancer of unknown primary of the head and neck. MRA Neck Without and With IV Contrast There is no relevant literature to support the use of MRA neck without and with IV contrast in the follow-up imaging or evaluation of suspected or known recurrence of treated cancer of the oral cavity, oropharynx, hypopharynx, larynx, or cancer of unknown primary of the head and neck.
Staging and Post Therapy Assessment of Head and Neck Cancer. FDG-PET/CT has been shown to be effective in identifying subclinical recurrences in the posttreatment setting [132,133]. The presence of posttreatment inflammatory change decreases the specificity of findings on FDG-PET/CT [131,134,135]. For this reason, imaging with FDG-PET/CT should ideally occur no earlier than 12 weeks after completion of therapy [117,118] to allow for treatment effects to subside, although imaging as early as 8 weeks after therapy has been suggested [136]. Concurrent infection can similarly give false-positive findings. One study found that the combination of MRI with FDG-PET/CT has the best detection of locoregional recurrence [128]. FDG-PET/CT has been found to accurately diagnose distant metastatic disease in the posttreatment setting [19,119] and may be indicated in treated advanced stage disease because of the increased rate of distant metastases. FDG-PET/MRI Skull Base to Mid-Thigh FDG-PET/MRI is new imaging modality with a growing body of evidence demonstrating the feasibility of use for routine clinical imaging including in the response assessment and evaluation of recurrence following treatment of cancer of the head and neck with FDG-PET/MRI performing similar to FDG/PET CT [137,138]. MRA Neck With IV Contrast There is no relevant literature to support the use of MRA neck with IV contrast in the follow-up imaging or evaluation of suspected or known recurrence of treated cancer of the oral cavity, oropharynx, hypopharynx, larynx, or cancer of unknown primary of the head and neck. MRA Neck Without and With IV Contrast There is no relevant literature to support the use of MRA neck without and with IV contrast in the follow-up imaging or evaluation of suspected or known recurrence of treated cancer of the oral cavity, oropharynx, hypopharynx, larynx, or cancer of unknown primary of the head and neck.