Advanced tools, including higher-resolution imaging, diffusion-weighted and diffusion-tensor sequences, and MRI perfusion techniques such as dynamic contrast-enhanced MRI show promise in improving anatomic and functional imaging [103-105]. These tools may help to distinguish between treatment change and recurrence; however, as of now, they are not consistently used in routine clinical practice. 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 follow-up imaging or the evaluation of known or suspected recurrence of treated cancer of the paranasal sinuses or nasal cavity. Combined pre- and postcontrast imaging provides the best opportunity to identify and delineate local tumor recurrence, distinguishing it from treatment-related change and in evaluating local tumor response. The absence of IV contrast limits the ability to accurately delineate the margins and the soft tissue extent of tumor. However, noncontrast MR sequences are routinely used to identify tumor recurrence and can define tumor extent, in particular marrow involvement, and are used in nodal assessment. Radiography Paranasal Sinuses There is no relevant literature to support the use of radiography of the paranasal sinuses in the follow-up imaging or evaluation of known or suspected recurrence of treated cancer of the paranasal sinuses or nasal cavity. US Neck US coupled with fine-needle aspiration and/or core-needle biopsy can be a useful tool in regional nodal evaluation following treatment of head and neck cancer [140]. 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].
Staging and Post Therapy Assessment of Head and Neck Cancer. Advanced tools, including higher-resolution imaging, diffusion-weighted and diffusion-tensor sequences, and MRI perfusion techniques such as dynamic contrast-enhanced MRI show promise in improving anatomic and functional imaging [103-105]. These tools may help to distinguish between treatment change and recurrence; however, as of now, they are not consistently used in routine clinical practice. 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 follow-up imaging or the evaluation of known or suspected recurrence of treated cancer of the paranasal sinuses or nasal cavity. Combined pre- and postcontrast imaging provides the best opportunity to identify and delineate local tumor recurrence, distinguishing it from treatment-related change and in evaluating local tumor response. The absence of IV contrast limits the ability to accurately delineate the margins and the soft tissue extent of tumor. However, noncontrast MR sequences are routinely used to identify tumor recurrence and can define tumor extent, in particular marrow involvement, and are used in nodal assessment. Radiography Paranasal Sinuses There is no relevant literature to support the use of radiography of the paranasal sinuses in the follow-up imaging or evaluation of known or suspected recurrence of treated cancer of the paranasal sinuses or nasal cavity. US Neck US coupled with fine-needle aspiration and/or core-needle biopsy can be a useful tool in regional nodal evaluation following treatment of head and neck cancer [140]. 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].