The use of CXR for detection of metastases has not been shown to improve prognosis because pulmonary metastatic disease detected on CXR tends to be diagnosed at a late stage when it is not as amenable to treatment [18]. CT Chest With IV Contrast CT chest with IV contrast can accurately identify pulmonary metastasis and can be used to detect thoracic nodal and skeletal metastases to the ribs or vertebrae. The most common site of metastatic involvement beyond the head and neck in up to 90% of cases is to the lungs. A distant second are the bones followed by the liver, brain, and other sites [108]. For this reason, CT of the chest may be considered in cases of increased risk of metastatic disease, in particular in patients with high-grade malignant tumors. CT chest confers a superior spatial and contrast resolution when compared to radiography, allowing for the detection of small pulmonary nodules [15]. The use of IV contrast may improve detection of mediastinal and hilar adenopathy, distinguishing nodes from mediastinal vessels and aid in delineation of soft tissue extension of skeletal metastatic disease. There is a paucity of relevant supportive literature specifically comparing the diagnostic performance of CT chest with IV contrast and CT chest without IV contrast. CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast in the evaluation of suspected or diagnosed cancer of a major salivary gland. CT Chest Without IV Contrast CT chest without IV contrast can accurately identify pulmonary metastasis and be used to detect thoracic nodal and skeletal metastases to the ribs or vertebrae. The most common site of metastatic involvement beyond the head and neck in up to 90% of cases is to the lungs. A distant second are the bones followed by the liver, brain, and other sites [108].
Staging and Post Therapy Assessment of Head and Neck Cancer. The use of CXR for detection of metastases has not been shown to improve prognosis because pulmonary metastatic disease detected on CXR tends to be diagnosed at a late stage when it is not as amenable to treatment [18]. CT Chest With IV Contrast CT chest with IV contrast can accurately identify pulmonary metastasis and can be used to detect thoracic nodal and skeletal metastases to the ribs or vertebrae. The most common site of metastatic involvement beyond the head and neck in up to 90% of cases is to the lungs. A distant second are the bones followed by the liver, brain, and other sites [108]. For this reason, CT of the chest may be considered in cases of increased risk of metastatic disease, in particular in patients with high-grade malignant tumors. CT chest confers a superior spatial and contrast resolution when compared to radiography, allowing for the detection of small pulmonary nodules [15]. The use of IV contrast may improve detection of mediastinal and hilar adenopathy, distinguishing nodes from mediastinal vessels and aid in delineation of soft tissue extension of skeletal metastatic disease. There is a paucity of relevant supportive literature specifically comparing the diagnostic performance of CT chest with IV contrast and CT chest without IV contrast. CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast in the evaluation of suspected or diagnosed cancer of a major salivary gland. CT Chest Without IV Contrast CT chest without IV contrast can accurately identify pulmonary metastasis and be used to detect thoracic nodal and skeletal metastases to the ribs or vertebrae. The most common site of metastatic involvement beyond the head and neck in up to 90% of cases is to the lungs. A distant second are the bones followed by the liver, brain, and other sites [108].