Ces radiol. 2021, 75(1):94-101 | DOI: 10.55095/CesRadiol2021/012

Diagnostic Approach to Head and Neck Cancer - a review of imaging methods and their application in clinical practiceReview article

Martina Kelblová¹, Pavla Urbánková², Marta Pažourková¹, Tomáš Holeček¹, Jiří Vaniček¹

¹ Klinika zobrazovacích metod FN u svaté Anny Brno a LF MU, Brno

² Klinika otorhinolaryngologie a chirurgie hlavy a krku FN u svaté Anny a LF MU, Brno

Imaging methods are an integral part of staging, treatment planning and surveillance of patients with head and neck cancer. Ultrasound (US) is noninvasive, cost-effective and useful tool for evaluation of cervical lymph nodes (N staging) and other superficial structures, but it is operator-dependent. CT of the neck is useful for imaging of primary tumor (T staging) and cervical lymph nodes (N staging), but in T staging it is limited by the artifacts of metallic dental fillings in the oral cavity and in lower poles of parotid glands. MRI of the neck has superior soft tissue contrast than CT, imaging is much less susceptible for dental filling artifacts, therefore it is prior to CT in T staging especially by tumors of oropharynx and oral cavity. In N staging, both methods (MRI and CT) are almost equivalent. FDG-PET/CT displays an increased metabolic activity of malignant cervical tumors and their regional and distant metastases (M staging). Therefore it is the method of definitive staging, restaging and method for detection of occult primary tumor. Advanced hybrid FDG-PET/MRI examination offers an advantage of detailed characterization of primary tumor together with definitive staging with significantly decreased radiation dose for patient.

Keywords: head and neck cancer, imaging methods, diagnostics, staging

Accepted: January 31, 2021; Published: March 1, 2021  Show citation