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Husband & Reznek's Imaging in Oncology
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Husband & Reznek's Imaging in Oncology
Husband & Reznek's Imaging in Oncology
eBook

Husband & Reznek's Imaging in Oncology

2020
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Overview
Computed tomography (CT) or magnetic resonance imaging (MRI) of the head and neck is frequently performed to evaluate most primary head and neck cancers. Most are mucosal and the mucosal extent can be evaluated best by visual inspection by the clinician. However, these tumours have the tendency to spread submucosally, and this extension into the deeper tissue planes may be impossible to detect by clinical examination. Some regions such as the base of the skull, pterygopalatine and infratemporal fossa, orbits, and brain are beyond clinical evaluation, although critical management decisions have to be made based on the involvement of these structures; imaging findings are of the utmost importance in such cases. Perineural and/or perivascular spread, leading to tumour progression, local or distant recurrences can be detected by imaging. Bone involvement, or cartilage invasion or destruction, can be visualized using CT or MRI. Metastatic adenopathies can be identified, sometimes still in a subclinical stage or in sites inaccessible by clinical examination, such as in the retropharyngeal or paratracheal lymph nodes. All of these findings can profoundly influence the staging and management of the patient with head and neck cancer. Finally, imaging may be used to monitor tumour response and to detect recurrent or persistent disease before it becomes clinically evident, possibly with a better chance for successful salvage. Besides imaging findings, the results of initial pathological specimens and smoking history are vital for patient management, and these patients should be formally staged in a multidisciplinary setting.