Radiologic diagnosis and staging of head and neck squamous cell carcinoma

The predominant extracranial head and neck cancer in adults is squamous cell carcinoma. The purpose of this article is to discuss the radiographic evaluation of these patients with CT scans or MR imaging before therapeutic intervention. Specific focus is given to the efficacy of CT scans and MR imaging, as an adjunct to clinical staging for evaluation of the primary tumor, and metastatic adenopathy. MR imaging, because of its improved soft tissue contrast and multiplanar capability, is probably superior to CT scans for evaluation of the primary tumor in patients with squamous cell carcinoma. CT scans, however, remain the gold standard for identifying metastatic adenopathy and in most institutions remain the study of choice for evaluating this patient population.