CT maxillofacial may not include the primary site in the hypopharynx or larynx and typically will not include the entire neck soft tissues, making it 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 use of CT maxillofacial without and with IV contrast in the initial staging of suspected or diagnosed cancer of the oral cavity or oropharynx or hypopharynx or larynx or cancer of unknown primary of the head and neck. CT Maxillofacial Without IV Contrast There is no relevant literature to support the use of CT maxillofacial without IV contrast in the initial staging of suspected or diagnosed cancer of the oral cavity or oropharynx or hypopharynx or larynx or cancer of unknown primary of the head and neck. 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. Contrast-enhanced CT (CECT) of the neck has the advantage of detailed anatomic delineation of the primary tumor site, aiding in the correct T staging as well as providing regional nodal staging of the neck. In oral cavity cancer, CECT has been shown to provide an accurate estimation of depth of invasion and tumor thickness in lesions >5 mm when compared to histopathologic findings, an important upstaging feature of oral cavity cancers [22-25], performing similar to MRI [26]. CT imaging also gives excellent delineation of osseous anatomy, including bony destruction by tumor with high sensitivity and specificity for osseous [27-29] and cartilage involvement [30], which are upstaging features. When compared to MRI, CECT of the neck performs similar or slightly better in correctly identifying osseous involvement [29,31,32].
Staging and Post Therapy Assessment of Head and Neck Cancer. CT maxillofacial may not include the primary site in the hypopharynx or larynx and typically will not include the entire neck soft tissues, making it 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 use of CT maxillofacial without and with IV contrast in the initial staging of suspected or diagnosed cancer of the oral cavity or oropharynx or hypopharynx or larynx or cancer of unknown primary of the head and neck. CT Maxillofacial Without IV Contrast There is no relevant literature to support the use of CT maxillofacial without IV contrast in the initial staging of suspected or diagnosed cancer of the oral cavity or oropharynx or hypopharynx or larynx or cancer of unknown primary of the head and neck. 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. Contrast-enhanced CT (CECT) of the neck has the advantage of detailed anatomic delineation of the primary tumor site, aiding in the correct T staging as well as providing regional nodal staging of the neck. In oral cavity cancer, CECT has been shown to provide an accurate estimation of depth of invasion and tumor thickness in lesions >5 mm when compared to histopathologic findings, an important upstaging feature of oral cavity cancers [22-25], performing similar to MRI [26]. CT imaging also gives excellent delineation of osseous anatomy, including bony destruction by tumor with high sensitivity and specificity for osseous [27-29] and cartilage involvement [30], which are upstaging features. When compared to MRI, CECT of the neck performs similar or slightly better in correctly identifying osseous involvement [29,31,32].