Samy Ammari, Presenter: Nothing to Disclose

Laurent Dercle MD, Abstract Co-Author: Nothing to Disclose

Stephane Temam, Abstract Co-Author: Nothing to Disclose

Pierre Blanchard, Abstract Co-Author: Nothing to Disclose

Martin Schlumberger, Abstract Co-Author: Nothing to Disclose

Clarisse Dromain MD, Abstract Co-Author: Nothing to Disclose

Jean Lumbroso MD, Abstract Co-Author: Nothing to Disclose

Francois Bidault, Abstract Co-Author: Nothing to Disclose

- Perineural spread is frequent - An optimal protocol is required

Introduction Head and neck cancer frequently spread along peripheral nerves. It most commonly involves the trigeminal (V) and the facial (VII) nerves, the rotondum (V2) and ovale (V3) foramens. Its frequency is variable (depending on tumor histologic type and location). Its diagnosis is crucial because it bears a poor prognosis (survival, local recurrence and metastasis) and warrants treatment adaptation. Teaching points The radiologic signs are an enlargement of the foramen or of cranial nerves associated with either a contrast enhancement asymmetry (MRI and cT-scan) or a hypermetabolism (FDG-PET/CT). Imaging and analysis must systematically include a coronal reconstruction (V2 and V3) and the imaging of the cavernous sinus. On MRI, a T1-weighted sequence with gadolinium chelate injection and suppression of fat signal is required. The primary advantage of a dedicated Head and Neck PET/CT protocol over the whole body acquisition is in the detection of small lymph node metastases. A baseline imaging after surgery and/or radiotherapy is particularly useful for the follow-up. Conclusions In head and neck cancer, the presence or absence of « extra-cranial » perineural extension should always be reported and an optimal protocol is required.

http://abstract.rsna.org/uploads/2014/14014694/14014694_194m.pdf

Ammari, S, Dercle, L, Temam, S, Blanchard, P, Schlumberger, M, Dromain, C, Lumbroso, J, Bidault, F, Contribution of F18-FDG-PET/CT and MRI to the Diagnosis of Perineural Extension in Head and Neck Malignancies.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014694.html