Surveillance imaging following treatment of head and neck cancer

Post-treatment surveillance is an important component in the treatment of head and neck cancers, especially as the proportion of human papilloma virus-positive cancers increases. Early detection of recurrences or second malignancies can increase success and minimize the toxicity of salvage treatment. Unfortunately, there are no consensus guidelines on the frequency and modality of post-treatment imaging. Computed tomography, ultrasound, magnetic resonance imaging and positron emission tomography-computed tomography (PET-CT) all have unique advantages and disadvantages when used as surveillance imaging. There is evidence that PET-CT may be the most sensitive of these modalities, but further research is needed to show an improvement in patient outcomes. Institutions will benefit most from a surveillance plan that is consistent and tailored to the individualized needs of their patients. This review focuses on the available evidence for different imaging modalities and general guidelines for developing an institution-specific practice pattern.