Although FDG-PET/CT is preferred for the restaging of advanced stage NPC because it allows for simultaneous detection of metastatic disease outside the thorax, CT chest may be considered for the screening of pulmonary metastatic disease. CT chest confers superior spatial localization and contrast resolution compared to radiography, allowing for the detection of small pulmonary nodules [15]. CT chest may also be indicated in patients with NPC associated with smoking and alcohol intake, increasing the risk for synchronous lung cancer. The use of IV contrast may improve detection of mediastinal and hilar adenopathy by distinguishing nodes from mediastinal vessels. Noncontrast CT chest may be considered as an alternative and is part of routine clinical practice, although there is paucity of relevant supportive literature evaluating the use of CT chest without IV contrast. CT Head With IV Contrast There is no relevant literature to support the use of CT head with IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. Although CT head may be able to delineate skull base and intracranial involvement, inclusion of the neck is recommended to evaluate for cervical adenopathy for staging purposes. CT Head Without and With IV Contrast There is no relevant literature to support the use of CT head without and with IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT Head Without IV Contrast There is no relevant literature to support the use of CT head without IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT Maxillofacial With IV Contrast There is no relevant literature to support the use of CT maxillofacial with IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT maxillofacial may provide
Staging and Post Therapy Assessment of Head and Neck Cancer. Although FDG-PET/CT is preferred for the restaging of advanced stage NPC because it allows for simultaneous detection of metastatic disease outside the thorax, CT chest may be considered for the screening of pulmonary metastatic disease. CT chest confers superior spatial localization and contrast resolution compared to radiography, allowing for the detection of small pulmonary nodules [15]. CT chest may also be indicated in patients with NPC associated with smoking and alcohol intake, increasing the risk for synchronous lung cancer. The use of IV contrast may improve detection of mediastinal and hilar adenopathy by distinguishing nodes from mediastinal vessels. Noncontrast CT chest may be considered as an alternative and is part of routine clinical practice, although there is paucity of relevant supportive literature evaluating the use of CT chest without IV contrast. CT Head With IV Contrast There is no relevant literature to support the use of CT head with IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. Although CT head may be able to delineate skull base and intracranial involvement, inclusion of the neck is recommended to evaluate for cervical adenopathy for staging purposes. CT Head Without and With IV Contrast There is no relevant literature to support the use of CT head without and with IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT Head Without IV Contrast There is no relevant literature to support the use of CT head without IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT Maxillofacial With IV Contrast There is no relevant literature to support the use of CT maxillofacial with IV contrast in treated cancer of the nasopharynx or EBV-associated cancer of unknown primary of the head and neck. CT maxillofacial may provide