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 NPC or EBV-associated 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 NPC or EBV-associated cancer of unknown primary of the head and neck. CT neck without IV contrast would not provide sufficient evaluation of the soft tissue extent of disease but may be complementary in the anatomic evaluation of the primary site in particular for the evaluation of osseous erosion. CTA Neck With IV Contrast There is no relevant literature to support the use of CTA neck with IV contrast for the initial staging of suspected or diagnosed NPC or EBV-associated 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 encroaching on the carotid arteries [41]. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT allows for the detection and localization of primary tumor site and identification of regional nodal disease and distant metastases. FDG-PET/CT alone is not considered sufficient in the initial staging of NPC because it does not provide detailed anatomic delineation of the primary site or detection of upstaging features needed for correct staging, including a tendency to underestimate the involvement of the skull base, brain, cavernous sinuses, and orbits compared to MRI [74,85,86]. FDG-PET/CT has also been found to have a higher false-negative rate than MRI for detection of retropharyngeal nodal disease [82]. FDG-PET/CT is useful for detecting cervical and distant metastases in patients with NPC [83] and demonstrates high sensitivity and specificity, when compared to CECT or MRI alone, in detecting nodal metastasis [82,84,85].
Staging and Post Therapy Assessment of Head and Neck Cancer. 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 NPC or EBV-associated 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 NPC or EBV-associated cancer of unknown primary of the head and neck. CT neck without IV contrast would not provide sufficient evaluation of the soft tissue extent of disease but may be complementary in the anatomic evaluation of the primary site in particular for the evaluation of osseous erosion. CTA Neck With IV Contrast There is no relevant literature to support the use of CTA neck with IV contrast for the initial staging of suspected or diagnosed NPC or EBV-associated 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 encroaching on the carotid arteries [41]. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT allows for the detection and localization of primary tumor site and identification of regional nodal disease and distant metastases. FDG-PET/CT alone is not considered sufficient in the initial staging of NPC because it does not provide detailed anatomic delineation of the primary site or detection of upstaging features needed for correct staging, including a tendency to underestimate the involvement of the skull base, brain, cavernous sinuses, and orbits compared to MRI [74,85,86]. FDG-PET/CT has also been found to have a higher false-negative rate than MRI for detection of retropharyngeal nodal disease [82]. FDG-PET/CT is useful for detecting cervical and distant metastases in patients with NPC [83] and demonstrates high sensitivity and specificity, when compared to CECT or MRI alone, in detecting nodal metastasis [82,84,85].