Anatomy and Corresponding Oncological Imaging of the Head and Neck

Abstract

Multidetector computed tomography (MDCT) has become the essential tool for the evaluation of malformations, trauma, and especially tumors of the head and neck region. Important for an adequate evaluation of pathologic findings in the head and neck region is a profound knowledge of the anatomic compartments, their content, and their neighboring relation. The head and neck region requires a very high soft tissue and bone resolution in order to precisely delineate the pathology. Therefore, CT scanning of different head and neck regions should be fitted for the special needs of the investigated anatomic region, for example, particular adjusted protocols for the evaluation of the larynx. The rapid technical improvement of MDCT in recent years has made CT the fist-choice imaging modality in many clinical conditions. The thinner slice collimation with improved anatomic detail visualization, the considerably reduced scanning time, and the possibility to calculate mul-tiplanar reconstructions (MPR) from the scanned volume data set have contributed to the ascent of CT scanning in head and neck oncology. The ability of cross-sectional imaging to exactly reveal pathologic conditions that are not detectable by endoscopy or in the setting of staging underestimated due to submucosal spread is a strength of MDCT. Another modality - dual-energy MDCT -has been established in recent years to image head and neck tumors (Toepker et al. 2014). Additionally, an even better method has been developed which is a hybrid imaging modality of positron emission tomography and MDCT, the so-called PET-CT. The aim of this chapter is to provide protocol suggestions for MDCT of the head and neck regions on the basis of a tailored review of the most important anatomic structures and their pathologic conditions (Fruehwald-Pallamar et al. 2011; Varoquaux et al. 2013).