Conversely, MRI has been reported to have higher sensitivity than CT in detecting cartilage invasion but similar specificity, an upstaging feature of larynx and hypopharyngeal malignancies [33,34]. In comparing the ability of CECT to fluorine-18-2- fluoro-2-deoxy-D-glucose (FDG)-PET/CT to accurately diagnose regional nodal disease, CECT performs similar or slightly inferior to FDG-PET/CT [35-39]. Contrast enhancement is imperative in order to correctly identify and outline the primary site, and distinguishing it from the surrounding normal soft tissues. The puffed-cheek technique, consisting of requesting that the patient inflate their cheeks with pursed lips while undergoing CT examination, allows for a greater delineation of oral cavity tumors, particularly those along the gingiva and buccal mucosa. The maneuver allows for the separation of tumor from normal mucosa and provides a clearer picture of the size and extent of disease [40]. CT Neck Without and With IV Contrast There is no relevant literature to support the use of CT neck 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 Neck Without IV Contrast There is no relevant literature to support the use of CT neck 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. CTA Neck With IV Contrast There is no relevant literature to support the use of CTA of the neck 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. CTA of the neck can be used to identify patients at high risk of bleeding in the instance of locally advanced disease with involvement encroaching on the carotid arteries [41].
Staging and Post Therapy Assessment of Head and Neck Cancer. Conversely, MRI has been reported to have higher sensitivity than CT in detecting cartilage invasion but similar specificity, an upstaging feature of larynx and hypopharyngeal malignancies [33,34]. In comparing the ability of CECT to fluorine-18-2- fluoro-2-deoxy-D-glucose (FDG)-PET/CT to accurately diagnose regional nodal disease, CECT performs similar or slightly inferior to FDG-PET/CT [35-39]. Contrast enhancement is imperative in order to correctly identify and outline the primary site, and distinguishing it from the surrounding normal soft tissues. The puffed-cheek technique, consisting of requesting that the patient inflate their cheeks with pursed lips while undergoing CT examination, allows for a greater delineation of oral cavity tumors, particularly those along the gingiva and buccal mucosa. The maneuver allows for the separation of tumor from normal mucosa and provides a clearer picture of the size and extent of disease [40]. CT Neck Without and With IV Contrast There is no relevant literature to support the use of CT neck 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 Neck Without IV Contrast There is no relevant literature to support the use of CT neck 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. CTA Neck With IV Contrast There is no relevant literature to support the use of CTA of the neck 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. CTA of the neck can be used to identify patients at high risk of bleeding in the instance of locally advanced disease with involvement encroaching on the carotid arteries [41].