Diagnostic Imaging in Head and Neck Cancer

Description

This succinct compendium focuses on the key practical aspects of head and neck cancer imaging. It also provides essential information on handling and analyzing imaging data. Head and neck cancer is the sixth most common cancer worldwide. CT and MRI imaging are absolutely crucial to accurate diagnosis and staging, and radiologists have to be especially familiar with the anatomy of that region of the body. In addition, they must be highly proficient in interpreting radiographic images in order to judge the patterns of metastasis, response to treatment, and the signs and patterns of recurrence. This concise but detailed book describes the latest imaging modalities for all types of head and neck cancer diagnosis in light of recent technological advances. Featuring abundant high-quality images supplemented by advice from experts on the management of each cancer, it is a valuable resource for diagnostic and general radiologists, as well as all medical staff involved in the management of head and neck cancers. Preface Contents 1: Perspectives and Trends in Diagnostic Imaging of Head and Neck Cancer 1.1 The Central Task: A Competent Report/Consultation 1.2 Knowledge Base for Progress Toward Becoming an Expert Head and Neck Cancer Imaging Consultant 1.2.1 The Beginnings: Becoming a “Student of the Disease” 1.3 The Fundamentals of Local and Regional Spread: The Basis of Eventual Expert Interpretive Skills and Appropriate Report Content 1.4 Perspectives on Current Appropriate Use of Diagnostic Imaging in Head and Neck Cancers 1.4.1 Evaluation of the Primary Site and Perineural Spread 1.4.2 Regional Adenopathy 1.4.3 Distant Metastases 1.4.4 Surveillance 1.5 Perspectives on Pitfalls, Distractions, and Ongoing Controversies in Head and Neck Cancer Imaging 1.5.1 Pitfall: Forgetting the Fundamentals 1.5.2 Potential Distraction: Tissue Specificity from Imaging Studies 1.5.3 Ongoing Controversy: What Is the Best Imaging Study to Detect Regional Adenopathy? 1.5.4 New Controversy: Is Routine Post-treatment Surveillance Justified? References 2: Diagnostic Imaging of Nasopharyngeal Carcinoma 2.1 Introduction 2.2 Anatomy 2.3 Pathology 2.4 AJCC/UICC TNM Classification 2.5 MRI Staging of the Primary Tumour (T-Classification) 2.5.1 T0 and T1 2.5.2 T2 2.5.3 T3 2.5.4 T4 2.6 MRI Staging of Nodal Disease (N Classification) (Table 2.2) 2.6.1 N1, N2 2.6.2 N3 2.7 MRI Staging of Distant Metastates (M Classification) 2.8 Radiotherapy for the Radiologist 2.9 Tumour Recurrence 2.9.1 Local Failure 2.9.2 Regional Failure 2.9.3 Distant Metastases 2.10 Imaging Tumour Recurrence 2.10.1 Nuclear Medicine 2.10.2 MRI 2.11 Complications of Radiotherapy 2.11.1 Radiation-Induced Central Nervous System (CNS) Injury 2.11.1.1 Injury to the Brain 2.11.1.2 Injury to the Cranial Nerves 2.11.2 Radiation-Induced Bone and Cartilage Injury 2.11.3 Radiation-Induced Vascular Injury 2.11.4 Radiation-Induced Mucosal Injury 2.11.5 Radiation-Induced Glandular (Exocrine and Endocrine) Injury 2.11.6 Radiation-Induced Neoplasms 2.12 Future Imaging Techniques References 3: Diagnostic Imaging of Oropharyngeal Cancer 3.1 Introduction 3.2 Oropharyngeal Squamous Cell Carcinoma 3.2.1 Demographics and Epidemiologic Features (Table 3.1) 3.2.2 Anatomical Considerations 3.2.3 Staging of Oropharyngeal Cancer 3.2.4 Imaging Features 3.3 Differential Diagnosis 3.3.1 Malignant Lymphoma 3.4 Summary References 4: Diagnostic Imaging of Oral Cavity Cancer 4.1 Epidemiology and Etiology 4.2 Anatomy of Oral Cavity: An Overview 4.3 TNM Classification 4.3.1 T Classification 4.3.2 N classification 4.4 Imaging Techniques 4.4.1 CT 4.4.2 MRI 4.5 Imaging of Oral Cancer 4.5.1 Mucosal Lip 4.5.2 Tongue 4.5.3 Lower Alveolar Ridge (Lower Gingival Cancer) 4.5.4 Upper Alveolar Ridge (Upper Gingival Cancer) 4.5.5 Retromolar Trigone 4.5.6 Floor of the Mouth 4.5.7 Buccal Mucosa 4.5.8 Hard Palate 4.5.9 Lymph Node Metastasis 4.6 Imaging of Post-treatment Change, Complication, and Recurrence 4.6.1 Post-treatment Change 4.6.2 Complications 4.6.3 Recurrence References 5: Diagnostic Imaging of Laryngeal and Hypopharyngeal Cancers 5.1 Introduction 5.2 Epidemiology 5.3 Anatomy 5.3.1 Anatomy of the Larynx 5.3.2 Anatomy of Hypopharynx 5.3.3 Deep Space of Larynx 5.3.3.1 Preepiglottic Space (PES) 5.3.3.2 Paraglottic Space (PGS) 5.3.3.3 Cricoid Area/Subglottic Space 5.3.4 Laryngeal Cartilage 5.4 Imaging Techniques 5.4.1 CT 5.4.2 MR Images 5.4.3 FDG-Pet 5.5 TNM Classification 5.5.1 Laryngeal Cancer 5.5.2 Hypopharyngeal Cancer 5.5.3 Nodal Category (N) 5.6 Spread Pattern and Site-Specific Imaging Evaluation 5.6.1 Laryngeal Cancer 5.6.1.1 Supraglottic Cancer 5.6.1.2 Glottic Cancer 5.6.1.3 Subglottic Cancer 5.6.1.4 Spread Pattern of Laryngeal Cancer (Deep Space) 5.6.1.5 Extralaryngeal Spread of the Laryngeal Cancer 5.6.2 Hypopharyngeal Cancer 5.6.2.1 Pyriform Sinus (PS) 5.6.2.2 Postcricoid (PC) 5.6.2.3 Posterior Wall (PW) 5.6.2.4 Spread Pattern of Hypopharyngeal Cancer into the Deep Space and Tissues 5.6.2.5 Extralaryngeal Spread of Hypopharyngeal Cancer 5.7 Cartilage Invasion 5.8 Lymph Node Metastasis 5.9 Distant Metastasis 5.10 Treatment Strategy 5.11 Posttreatment Imaging 5.11.1 Postoperative Imaging 5.11.2 Postradiation Imaging 5.11.3 Posttreatment Surveillance Imaging References 6: Diagnostic Imaging of Metastatic Nodal Disease 6.1 Introduction 6.2 Anatomy of Normal Lymph Node 6.3 Lymph Node Classification 6.3.1 Imaging-Based Classification 6.3.2 Basic Anatomic Classification 6.4 Common Lymphatic Drainage of HNSCC 6.4.1 Drainage Patterns to Lymph Nodes 6.4.2 Drainage Patterns from the Primary Site 6.5 Imaging Techniques 6.5.1 Contrast-Enhanced CT and MRI 6.5.2 US 6.5.3 FDG-PET/CT 6.6 Imaging Features of Metastatic Nodes 6.6.1 Size 6.6.2 Shape 6.6.3 Grouping 6.6.4 Focal Nodal Inhomogeneity or Central Necrosis 6.6.4.1 Cystic Nodal Metastasis 6.6.5 Extranodal Extension (ENE) 6.6.5.1 Carotid Arterial Invasion 6.6.5.2 Prevertebral Fascia Invasion 6.6.6 Vascular Patterns on US 6.7 Nodal Staging of HNSCC 6.7.1 Unknown Primary Tumor 6.8 Treatment Assessment 6.8.1 Prediction of Treatment Response to (Chemo)Radiotherapy 6.8.2 Assessment for Post (Chemo)Radiotherapy 6.8.3 Posttreatment Surveillance References 7: Diagnostic Imaging of Sinonasal Tumors 7.1 Introduction 7.2 Sinonasal SCC 7.2.1 General Knowledge 7.2.2 Maxillary Sinus 7.2.3 Nasal Cavity 7.2.4 Ethmoid Sinus and Frontal Sinus 7.2.5 Symptoms 7.2.6 Extension 7.2.7 Diagnostic Imaging 7.2.8 Perineural Spread 7.2.9 Treatment 7.3 Other Tumors: Non-SCCs and Nonepithelial Tumors 7.3.1 Adenoid Cystic Carcinoma 7.3.1.1 Imaging Features 7.3.2 Sinonasal Undifferentiated Carcinoma 7.3.2.1 Imaging Features 7.3.3 Olfactory Neuroblastoma 7.3.3.1 Imaging Features 7.3.4 Mucosal Malignant Melanoma 7.3.4.1 Diagnostic Imaging 7.3.5 Non-Hodgkin’s Lymphomas of the Sinonasal Cavity 7.3.5.1 Diffuse Large B-Cell Lymphoma Diagnostic Imaging 7.3.5.2 Extranodal Natural Killer/T-Cell Lymphoma Diagnostic Imaging 7.3.6 Inverted Papilloma 7.3.6.1 Diagnostic Imaging References 8: Diagnostic Imaging of Salivary Gland Tumors 8.1 Introduction 8.2 Clinical Features 8.3 Histopathology 8.4 Staging 8.5 Radiological Imaging 8.6 Mucoepidermoid Carcinoma 8.7 Adenoid Cystic Carcinoma 8.8 Acinic Cell Carcinoma 8.9 Secretory Carcinoma 8.10 Polymorphous Adenocarcinoma 8.11 Adenocarcinoma NOS 8.12 Salivary Duct Carcinoma 8.13 Epithelial-Myoepithelial Carcinoma 8.14 Carcinoma ex Pleomorphic Adenoma 8.15 Poorly Differentiated Carcinoma 8.16 Summary References 9: Diagnostic Imaging of Perineural Spread 9.1 The Basics: Growth Along Nerves and Vessels (Perineural and Perivascular Spread) 9.2 Imaging Structural Manifestations 9.3 Two General Clinical Scenarios 9.3.1 Skin Cancer 9.3.2 Mucosal Origin Cancers and/or Those with Known Neurotrophic Tendencies 9.4 Imaging Modalities 9.5 General Treatment Implications 10: PET in the Diagnosis of Head and Neck Cancer 10.1 FDG-PET Image Acquisition 10.1.1 Patient Preparation 10.1.2 Scanning Protocols 10.1.3 PET/MR 10.2 FDG-PET Image Evaluation 10.2.1 Quantification and Visual Inspection of FDG Uptake 10.2.2 Tumor Heterogeneity 10.3 TNM Staging by PET 10.3.1 Initial Treatment Strategy 10.3.2 T Staging 10.3.3 N Staging 10.3.4 M Staging 10.3.5 Unknown Primary Tumor 10.4 Patients with HPV Positive Oropharyngeal Cancer 10.5 Implication for Patient Management 10.5.1 Scan Timing for Therapy Assessment 10.5.2 Prognostic Value of Baseline FDG-PET 10.5.3 Prognostic Value of Intratreatment or Posttreatment FDG-PET 10.5.4 PET/CT Evaluation for Residual Nodal Disease After CRT 10.5.5 Surveillance Following Definitive Treatment of HNC 10.6 Summary References