FDG-PET/CT Skull Base to Mid-Thigh While there is established literature regarding the use of FDG-PET/CT for staging and surveillance of parotid malignancy, FDG-PET/CT is not an initial imaging study for evaluation. FDG-PET/MRI Skull Base to Mid-Thigh There is no evidence to support the use of FDG-PET/MRI for evaluation of a new parotid mass. Arteriography Cervicocerebral There is no evidence to support the use of catheter angiography for evaluation of a new parotid mass. Fluoroscopy Sialography Parotid In the absence of acute infection, conventional fluoroscopic parotid sialography may provide detailed assessment of the parotid ducts if there is a clinical concern for duct obstruction. Neck Mass/Adenopathy Variant 4: Child. Neck mass(es). Not parotid region or thyroid. Initial imaging. In children who present with neck masses, congenital etiologies should be added to differential diagnostic considerations [6,95] in addition to infectious and malignant etiologies. Clinical examination features and correlation with onset, change in mass size, fluctuance, fever, overlying skin erythema, or recent trauma are important to guiding imaging. CT Neck CT with IV contrast can be performed in children suspected of a having a malignancy or a deep neck infection that may require surgery [21,29,96]. CT has reduced or absent sedation requirements given the shorter examination time. Dual phase (without and with IV contrast) is not usually necessary, as most sialoliths are not obscured by contrast. [20]. CT performed only without IV contrast may be useful in some cases. Advances in lower dose protocols and reconstruction vary among vendors [32], and all imaging should reflect ALARA practices [33]. CTA Neck There is no evidence to support the use of CTA for evaluation of a palpable neck mass in a child. MRI Neck MRI of the neck can be performed in children suspected of having a malignancy or a deep neck abscess that may require surgical drainage [21,29,96].
Neck Mass Adenopathy. FDG-PET/CT Skull Base to Mid-Thigh While there is established literature regarding the use of FDG-PET/CT for staging and surveillance of parotid malignancy, FDG-PET/CT is not an initial imaging study for evaluation. FDG-PET/MRI Skull Base to Mid-Thigh There is no evidence to support the use of FDG-PET/MRI for evaluation of a new parotid mass. Arteriography Cervicocerebral There is no evidence to support the use of catheter angiography for evaluation of a new parotid mass. Fluoroscopy Sialography Parotid In the absence of acute infection, conventional fluoroscopic parotid sialography may provide detailed assessment of the parotid ducts if there is a clinical concern for duct obstruction. Neck Mass/Adenopathy Variant 4: Child. Neck mass(es). Not parotid region or thyroid. Initial imaging. In children who present with neck masses, congenital etiologies should be added to differential diagnostic considerations [6,95] in addition to infectious and malignant etiologies. Clinical examination features and correlation with onset, change in mass size, fluctuance, fever, overlying skin erythema, or recent trauma are important to guiding imaging. CT Neck CT with IV contrast can be performed in children suspected of a having a malignancy or a deep neck infection that may require surgery [21,29,96]. CT has reduced or absent sedation requirements given the shorter examination time. Dual phase (without and with IV contrast) is not usually necessary, as most sialoliths are not obscured by contrast. [20]. CT performed only without IV contrast may be useful in some cases. Advances in lower dose protocols and reconstruction vary among vendors [32], and all imaging should reflect ALARA practices [33]. CTA Neck There is no evidence to support the use of CTA for evaluation of a palpable neck mass in a child. MRI Neck MRI of the neck can be performed in children suspected of having a malignancy or a deep neck abscess that may require surgical drainage [21,29,96].