A guide to cross-sectional head and neck cancer imaging

This multidisciplinary guide provides a comprehensive overview of cross-sectional imaging techniques used in the diagnosis, staging, and management of head and neck cancer (HNC). As the eighth most common cancer in the UK, HNC presents significant diagnostic challenges due to its complex anatomy, diverse tumour sub-types, and frequent late stage presentation. The article outlines the strengths and limitations of key imaging modalities – CT, MR, PETCT and ultrasound – emphasising their roles in evaluating primary tumours, lymph node involvement and disease recurrence.

CT is highlighted as the first-line modality for assessing malignancies in dynamic regions like the larynx and hypopharynx, offering rapid acquisition and excellent anatomical detail. MRI excels in soft tissue contrast and is preferred for evaluating skull base invasion and perineural spread. PETCT combines metabolic and anatomical imaging, aiding in the detection of occult primaries and treatment response assessment. Ultrasound is praised for its high resolution and utility in guiding biopsies, particularly in thyroid and salivary gland evaluations.

Staging systems are also discussed, notably the The American Joint Committee on Cancer’s HPV-specific algorithm, and common pathologies such as squamous cell carcinoma, thyroid cancer and salivary gland tumours. Interpretation tips for each modality are provided to enhance diagnostic accuracy. The guide concludes by stressing the importance of a multidisciplinary approach, ongoing education and clinical correlation to ensure optimal patient outcomes in this evolving field.

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