However, CT maxillofacial will typically not include evaluation of the neck and would therefore be inadequate for the staging of regional lymphadenopathy. Assessment of Head and Neck Cancer CT Maxillofacial Without and With IV Contrast There is no relevant literature to support the routine use of CT maxillofacial without and with IV contrast in follow- up imaging or evaluation of known or suspected recurrence of treated cancer of a major salivary gland. CT Maxillofacial Without IV Contrast There is no relevant literature to support the routine use of CT maxillofacial without IV contrast in follow-up imaging or evaluation of known or suspected recurrence of treated cancer of a major salivary gland. CT Neck With IV Contrast Although protocols vary across institutions, for the purposes of this document, CT of the neck includes coverage from the top of the frontal sinuses down to the level of the aortic arch, with thin slices, multiplanar reformats, and both soft tissue and bony algorithms. CECT of the neck allows for the detection and localization of recurrent tumor and the evaluation of regional nodal disease. CT is also used to monitor treatment changes and assess for treatment complications such as infection or osteoradionecrosis. Evaluation of the treated neck is very often complicated by significant treatment related changes that can be difficult to distinguish from persistent disease after therapy or recurrence. Soft tissue resolution of CT is considered inferior to that of MRI [108], and certain cancers such as adenoid cystic carcinoma, mucoepidermoid carcinoma, and acinic cell carcinomas may lack significant contrast enhancement on CT, rendering the detection of recurrence difficult by this modality [111]. Furthermore, MRI is considered superior in the detection of perineural spread and the soft tissue extent of disease [107,108].
Staging and Post Therapy Assessment of Head and Neck Cancer. However, CT maxillofacial will typically not include evaluation of the neck and would therefore be inadequate for the staging of regional lymphadenopathy. Assessment of Head and Neck Cancer CT Maxillofacial Without and With IV Contrast There is no relevant literature to support the routine use of CT maxillofacial without and with IV contrast in follow- up imaging or evaluation of known or suspected recurrence of treated cancer of a major salivary gland. CT Maxillofacial Without IV Contrast There is no relevant literature to support the routine use of CT maxillofacial without IV contrast in follow-up imaging or evaluation of known or suspected recurrence of treated cancer of a major salivary gland. CT Neck With IV Contrast Although protocols vary across institutions, for the purposes of this document, CT of the neck includes coverage from the top of the frontal sinuses down to the level of the aortic arch, with thin slices, multiplanar reformats, and both soft tissue and bony algorithms. CECT of the neck allows for the detection and localization of recurrent tumor and the evaluation of regional nodal disease. CT is also used to monitor treatment changes and assess for treatment complications such as infection or osteoradionecrosis. Evaluation of the treated neck is very often complicated by significant treatment related changes that can be difficult to distinguish from persistent disease after therapy or recurrence. Soft tissue resolution of CT is considered inferior to that of MRI [108], and certain cancers such as adenoid cystic carcinoma, mucoepidermoid carcinoma, and acinic cell carcinomas may lack significant contrast enhancement on CT, rendering the detection of recurrence difficult by this modality [111]. Furthermore, MRI is considered superior in the detection of perineural spread and the soft tissue extent of disease [107,108].