MRI head without and with IV contrast may be a useful adjunct to further delineate advanced intracranial extension of disease when suspected based on clinical grounds or prior imaging. 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 cancer of the paranasal sinuses or nasal cavity. MRI Orbits, Face, and Neck With IV Contrast There is no relevant literature to support the use of MRI orbits, face, and neck with IV contrast in the initial staging of suspected or diagnosed cancer of the paranasal sinuses or nasal cavity. Assessment of Head and Neck Cancer MRI Orbits, Face, and Neck Without and With IV Contrast MRI 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 [96], which is a key component in the T staging of disease and essential for surgical planning. Perineural tumor spread is more easily recognized with MRI compared to CT, as is the regional extension to neighboring structures such as the orbits, dura, and brain, and subtle marrow involvement [96]. Furthermore, the superior soft tissue contrast resolution of MRI can better distinguish tumors from sinus inflammatory changes and retain secretions compared to CT. Advanced tools, including higher- resolution imaging, diffusion-weighted and diffusion-tensor sequences, and MR 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 benign and malignant disease, however, as of now they are not consistently used in routine clinical practice. Combined pre- and postcontrast imaging provides the best opportunity to correctly identify and delineate the primary site, distinguishing it from the surrounding normal soft tissues.
Staging and Post Therapy Assessment of Head and Neck Cancer. MRI head without and with IV contrast may be a useful adjunct to further delineate advanced intracranial extension of disease when suspected based on clinical grounds or prior imaging. 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 cancer of the paranasal sinuses or nasal cavity. MRI Orbits, Face, and Neck With IV Contrast There is no relevant literature to support the use of MRI orbits, face, and neck with IV contrast in the initial staging of suspected or diagnosed cancer of the paranasal sinuses or nasal cavity. Assessment of Head and Neck Cancer MRI Orbits, Face, and Neck Without and With IV Contrast MRI 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 [96], which is a key component in the T staging of disease and essential for surgical planning. Perineural tumor spread is more easily recognized with MRI compared to CT, as is the regional extension to neighboring structures such as the orbits, dura, and brain, and subtle marrow involvement [96]. Furthermore, the superior soft tissue contrast resolution of MRI can better distinguish tumors from sinus inflammatory changes and retain secretions compared to CT. Advanced tools, including higher- resolution imaging, diffusion-weighted and diffusion-tensor sequences, and MR 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 benign and malignant disease, however, as of now they are not consistently used in routine clinical practice. Combined pre- and postcontrast imaging provides the best opportunity to correctly identify and delineate the primary site, distinguishing it from the surrounding normal soft tissues.