Radiologists work closely with ohsu mri techs in the art of creating optimal images from current technology. Mri is commonly used for monitoring patients after therapy. Mri findings, including diffusionweighted imaging and. As high temporal resolution is needed for the dce mri postprocessing to obtain higher accuracy parameters maps, the coverage of a dce mri protocol. Imaging frequently reveals a soft tissue mass with sharply defined boundaries in the posterior nasopharynx both ct and mri can be used. The juvenile nasopharyngeal angiofibroma is a benign neoplasm of the posterior nasopharynx it occurs almost exclusively in adolescent males, with an average age at diagnosis of 15 years. Selection of our books indexed in the book citation index in web of science. Mribased radiomics signature is a quantitative prognostic. Pdf mri and ct of nasopharyngeal carcinoma researchgate. Nasopharyngeal cancer is a disease in which malignant cancer cells form in the tissues of the nasopharynx. This mri brain cross sectional anatomy tool is absolutely free to use. It outlines all sequences and protocols currently applied in our mri section. Designed to meet the needs of todays radiologists and mri technologists, musculoskeletal mri positioning and protocols. Mri scan of the neck and nasopharynx, chest radiography, and abdominal.
From october 1982 to august 1984, 30 previously untreated patients with biopsyproven carcinoma of the nasopharynx, stage iii 26. Males are more commonly affected, with a male to female ratio of 3. Mri is however less available, has less anatomical coverage. Imaging of nasopharyngeal inflammatory pseudotumours. Magnetic resonance imaging staging of nasopharyngeal carcinoma. A prospective protocol for nasopharyngeal carcinoma in. Get detailed information about the treatment of newly diagnosed and recurrent nasopharyngeal.
Adenoids enlarge during early childhood and reach a maximum size in children aged 3 to 7 years after which they usually undergo appreciable atrophy 2,3. Nasopharyngeal cancer is a rare type of head and neck cancer. Disease processes can spread to and from the nasopharynx through welldefined anatomic pathways. The mri scan should cover the head and neck from just above the skull base to just below the suprasternal notch. Fast and ultrafast 2d ge sequences should be applied in the evaluation. Complementary roles of mri and endoscopic examination in. Nasopharyngeal np lymphoma is a rare primary malignancy of the head and neck and represents a minority of malignancies originating from the nasopharynx. Skull base imaging, anatomy, pathology and protocols. The objective of this report is to emphasize that, although rare, nasopharyngeal. Mri and ct scans of the head and brain cpt code list 70450, 70460, 70559 procedure code and description. The protocol for routine mri of a nasopharyngeal mass includes unenhanced t1weighted images to detect skull base involvement and fat planes in at least an axial and sagittal plane.
Nasopharyngeal carcinoma npc is uncommon in the united states and in most countries of the world. Therefore, although our mri screening protocol took only 15 minutes and was dedicated to the nasopharyngeal region, we are evaluating even shorter mri protocols. For skull base and nasopharyngeal tumours mri is superior to ct. It starts in the nasopharynx, the upper part of the throat behind the nose and near the base of. Imaging protocol and gross tumor volume comparison between mri, ct, and petct. Early responses assessment of neoadjuvant chemotherapy in. Use of postfall protocols, with standing imaging orders, do not provide. Mri and ct scans of the head and brain cpt code list. Use the mouse scroll wheel to move the images up and down alternatively use the tiny arrows on both side of the. This page is for ohsus mri technologists and physicians.
A prospective protocol for nasopharyngeal carcinoma in children and adolescents. The staging mri protocol for npc varies from center to center. Mri detected cranial nerve involvement in nasopharyngeal carcinoma li li, wenxin yuan, lizhi liu and chunyan cui. Although npc accounts for less than 1% of all cancers in americans, it. This site provides clear and easily accessible guide to many of the practical aspects of mri including mri protocols, mri planning, mri anatomy, mri techniques, mri safety and much. The focus of this chapter will be on nasopharyngeal carcinoma, with a brief overview of a few other lesions. In addition, a basic anatomy section has been added at the beginning of each examination area. Mri scans with gadolinium contrast of the head and neck region and appropriate imaging studies in. Shoulderpost gadolinium indirect mr arthrogram inject standard dose of iv contrast and wait 20 minutes before scanning 3. Nasopharyngeal cancer npc is a unique disease that shows clinical behaviour, epidemiology and histopathology that is different from that of other squamous cell carcinomas of the head. The nasal part of the pharynx pars nasalis pharyngis. Imaging protocols in head and neck cancer neuroradiology, dept of clinical neurosciences, western general. Extension of nasopharyngeal tumors, especially into the skull base and the deep facial spaces, is well.
The skull base is the major bony and soft tissue interface for the intracranial and extracranial compartments. It starts in the upper part of your throat, behind the nose. Mridetected cranial nerve involvement in nasopharyngeal. Detection of nasopharyngeal carcinoma by mr imaging. Nasopharyngeal carcinoma accounts for 70% of all primary malignancies of the nasopharynx, and although rare in. The focus of this chapter will be on nasopharyngeal. Our radiologists work closely with ohsu mri technologists in the art of creating optimal images using current technology. Nasopharyngeal carcinoma npc, or nasopharynx cancer, is the most common cancer originating in the nasopharynx, most commonly in the posterolateral nasopharynx or. Target delineation for head and neck cancer nancy lee, m. Nasopharyngeal cancer treatment options include radiation therapy, chemoradiation followed by adjuvant chemotherapy, surgery, and chemotherapy. Mri examination was performed on two cats with a histologically confirmed nasopharyngeal polyp and one cat with lymphoma. The main imaging tools of the nasopharyngeal region are ct, magnetic resonance imaging mri, and positron emission tomography pet.
The nasopharynx forms the superiormost part of the pharynx, in continuity with the inferior oropharynx, and the posterior continuation of the anterior nasal cavity. Do you ever get tired of calling patients back because the scan planes were not angled properly. Planning and positioning in mri elsevier australia. Juvenile nasopharyngeal angiofibroma iowa head and neck. Nasopharyngeal carcinoma radiology reference article. Neuroradiology protocols currently applied in our mri section.
Mri protocols are more varied between sites and equipment, and some. Treatment protocols for nasopharyngeal cancers are provided below, including generalized firstline therapy based on stage. Nasopharyngeal carcinoma accounts for 70% of all primary malignancies of the nasopharynx, and although rare in western populations, it is one of the most common malignancies encountered in asia, especially china 1,35. This site provides clear and easily accessible guide to many of the practical aspects of mri including mri protocols, mri planning, mri anatomy, mri techniques, mri safety and much more. Normal nasopharyngeal mucosa contains a highly variable amount of lymphoid tissue, which is most abundant in the posterior superior wall and roof, where it commonly is termed an adenoid. Extension of nasopharyngeal tumors, especially into the skull base. Extension of nasopharyngeal tumors, especially into the skull base and the deep facial spaces, is well illustrated on. Combined treatment in carcinoma of the nasopharynx. The purpose of this study was to describe the mri findings of inflammatory pseudotumours ipts involving the nasopharynx and to differentiate ipts from nasopharyngeal carcinoma. Secondly, to introduce dce mri in nasopharynx region, some challenges must be overcome, such as image coverage of this region. Acrasnrspr practice parameter for the performance of magnetic resonance imaging mri of the head and neck preamble this document is an educational tool. The nasopharynx is located at the crossroads between the skull base superiorly, the nasal cavity anteriorly, and the oropharynx inferiorly. Mri has become the main imaging protocol for npc diagnosis. Mri is however less available, has less anatomical coverage, takes significantly longer and is.
Fourthly, currently the cost of performing mri may prohibit its widespread application in a screening population. Ct scan thickness should be 3 mm or less for treatment planning. Ethnic background and being exposed to the epsteinbarr virus can affect the risk of nasopharyngeal cancer. Mri protocols, mri planning, mri techniques and anatomy. Assessment of retropharyngeal and cervical lymphadenopathy is important for treatment planning. From etiology to clinical practice discusses npc from basic science, to clinical management through the perspective of members of the centre for nasopharyngeal. Children often present with enlargement of the nasopharyngeal soft tissues, which is usually due to benign hypertrophy of adenoids. Nasopharyngeal cancer is a type of head and neck cancer. Its anatomy is complex, containing multiple traversing foramina. In areas of the world in which nasopharyngeal carcinoma npc is endemic, there is high clinical suspicion of the disease in patients who present with head and neck symptoms.