Correlation of clinical, surgical, pathologic, and MR fat suppression results for head and neck cancer

Magnetic resonance (MR) imaging provides superior soft tissue delineation of head and neck tumors compared to previous radiologic studies. Further refinements using fat suppression and gadolinium (Gd-DTPA) enhancement have added to these improved images. We performed MR studies of 16 patients with head and neck tumors with detailed clinical, surgical, and pathologic information. MR studies included standard spin-echo T1-weighted images (T1WI) with and without fat suppression and T2-weighted images (T2WI) with fat suppression. Gadolinium was also administered with fat suppression. Conventional and paired fat suppression MR images were compared by a grading system. Post-Gd-DTPA fat suppression T1WI, and T2WI with fat suppression, showed superior sensitivity for tumor delineation when compared to conventional T1WI. Fat suppression T2WI was the best technique to delineate squamous cell carcinoma both in the primary site and regional lymph nodes. Clinical, surgical, and pathologic results correlated perfectly with imaging findings. These refinements in MR imaging represent a significant advance in the radiologic evaluation of head and neck tumors.