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Imaging of Head and Neck Cancers

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Abstract

Head and neck cancers (HNC) include a variety of neoplasms that are traditionally associated with high morbidity and mortality. Patients with these malignancies, of which squamous cell cancer is the most common, require a multidisciplinary approach to determine optimal treatment and follow-up. Treatment depends on TNM staging, which is determined using a combination of objective findings including physical examination, endoscopies, and importantly cross-sectional imaging. CT and MR imaging are the mainstays of cross-sectional imaging and are used extensively to stage and characterize these tumors. The goals of appropriate imaging is to establish the extent and size of tumor, assess nodal disease in the neck, look for perineural spread, distinguish tumor recurrence from postoperative- or postradiation-related changes, and monitor response to treatment. Cross-sectional imaging supplements and complements anatomic and pathologic changes of the neck.

CT and MRI are both used to image HNC. They both have their own strengths and weaknesses, and these should be carefully considered before choosing the respective study. Other techniques such as MR perfusion, MR spectroscopy, and MR magnetization transfer have the ability to measure functional parameters such as tissue perfusion that can be integrated with other clinical and radiological information to assess disease progression. Imaging with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been found to be superior to CT and MR alone. New applications including combined PET/CT and PET/MR provide additional anatomical localization detail to assess for tumor response to treatment, tumor progression, and distant metastasis as well as spot unknown primary carcinomas or synchronous second tumor. With the rise in HPV-related tumors, imaging techniques can be used to identify these patients. From methodological development, these morphologic investigations are making the critical transition to preclinical and clinical validating methods and eventually to widespread clinical tools.

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Authors and Affiliations

  1. University of Michigan, Ann Arbor, MI, USA

    Taha S. Meraj MD

  2. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Suyash Mohan MD

  3. Department of Radiology, University of Michigan Health System, 1500 E Medical Center Drive, B2A209, UMHS, Ann Arbor, MI, 48109, USA

    Gaurang V. Shah MD

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Correspondence to Gaurang V. Shah MD .

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  1. Department of Radio-Oncology, Genolier Swiss Medical Network, Genolier, Switzerland

    Jacques Bernier

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Meraj, T.S., Mohan, S., Shah, G.V. (2016). Imaging of Head and Neck Cancers. In: Bernier, J. (eds) Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-27601-4_13

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