CT Maxillofacial Without and With IV Contrast There is no relevant literature to support the routine use of CT maxillofacial without and with IV contrast in the initial staging of suspected or diagnosed cancer of a major salivary gland. CT Maxillofacial Without IV Contrast There is no relevant literature to support the routine use of CT maxillofacial without IV contrast in the initial staging of suspected or diagnosed cancer of a major salivary gland. CT maxillofacial 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. However, CT maxillofacial will typically not include evaluation of the neck and would therefore be inadequate for the staging of regional lymphadenopathy when performed alone and may best be used in combination with MRI or FDG-PET/CT. CT Neck With IV Contrast Although protocols vary across institutions, for the purposes of this document, CT of the neck includes coverage from the top of the frontal sinuses down to the level of the aortic arch, with thin slices, multiplanar reformats, and both soft tissue and bony algorithms. CECT of the neck can give detailed anatomic delineation of the primary tumor site and adjacent anatomy, as well as provide regional nodal staging of the neck. Soft tissue resolution of CT is considered inferior to that of MRI [108], and certain cancers such as adenoid cystic carcinoma, mucoepidermoid carcinoma, and acinic cell carcinomas may lack significant contrast enhancement on CT, making their detection difficult by this modality [111]. Furthermore, MRI is considered superior in the detection of perineural spread and the soft tissue extent of disease [107,108], which are features needed for accurate T staging. Generally, CT is reserved for patients when there are indeterminate findings on MRI regarding osseous invasion [107,108].
Staging and Post Therapy Assessment of Head and Neck Cancer. CT Maxillofacial Without and With IV Contrast There is no relevant literature to support the routine use of CT maxillofacial without and with IV contrast in the initial staging of suspected or diagnosed cancer of a major salivary gland. CT Maxillofacial Without IV Contrast There is no relevant literature to support the routine use of CT maxillofacial without IV contrast in the initial staging of suspected or diagnosed cancer of a major salivary gland. CT maxillofacial 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. However, CT maxillofacial will typically not include evaluation of the neck and would therefore be inadequate for the staging of regional lymphadenopathy when performed alone and may best be used in combination with MRI or FDG-PET/CT. CT Neck With IV Contrast Although protocols vary across institutions, for the purposes of this document, CT of the neck includes coverage from the top of the frontal sinuses down to the level of the aortic arch, with thin slices, multiplanar reformats, and both soft tissue and bony algorithms. CECT of the neck can give detailed anatomic delineation of the primary tumor site and adjacent anatomy, as well as provide regional nodal staging of the neck. Soft tissue resolution of CT is considered inferior to that of MRI [108], and certain cancers such as adenoid cystic carcinoma, mucoepidermoid carcinoma, and acinic cell carcinomas may lack significant contrast enhancement on CT, making their detection difficult by this modality [111]. Furthermore, MRI is considered superior in the detection of perineural spread and the soft tissue extent of disease [107,108], which are features needed for accurate T staging. Generally, CT is reserved for patients when there are indeterminate findings on MRI regarding osseous invasion [107,108].