Head and Neck Imaging

Abstract

CT is an important imaging method in the head and neck region and accumulating evidence indicates an added value of dual-energy CT (DECT) reconstructions in this area, especially for head and neck cancer. In general, DECT derived low keV virtual monoenergetic images (VMI) facilitate an increased contrast and subsequently an improved delineation of tumor tissue and its boundaries, vessels, and lymph nodes. High keV VMI are an established tool in the metal artifact reduction arsenal and are beneficial in the assessment of tumorous cartilage invasion. Material-specific DECT reconstructions, such as quantitative iodine maps might allow for a better tissue characterization or distinction of benign and metastatic lymph nodes. While VMI and iodine maps are both relatively well researched and already in frequent clinical use, data on radiomics is comparatively sparse and principal application across different platforms is not yet given. Overall, a multiparametric approach of various DECT reconstructions seems most promising to develop a clinically relevant advantage over conventional CT, allowing for a more accurate imaging of head and neck pathologies to achieve the best possible patient treatment. The following chapter will provide an overview of the most significant applications of multiparametric DECT in head and neck imaging and outline challenges and obstacles to further deployment, as well as future developments.