Head and Neck Imaging

Baseline study

first follow-up CT or MR study obtained after surgical, radiation or combined treatment, e.g. for a malignant head and neck neoplasm. Such a study allows treatment-caused changes in the head and neck tissues to be documented. By comparing subsequent studies with the baseline study, it becomes possible to detect with more confidence tumour recurrences or treatment complications, and to do this at an earlier stage than is possible with clinical follow-up alone. There is evidence that the baseline study itself carries important predictive information regarding the eventual local outcome ( Fig.1). Probably the best time to obtain such a baseline study is about 3-6 months after the end of treatment. Also, see radiation therapy tissue changes.

 

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Fig.1

a. Baseline CT study obtained 3 months after the end of radiotherapy for a left-sided supraglottic cancer. Some obliteration of the fat in the left paraglottic space is seen (arrows). This is not an expected finding in the larynx after radiotherapy, and, depending on the clinical findings, this requires at the very least further imaging follow-up. b. Same patient, 5 months after radiotherapy; a focal mass (arrows) has developed within the original tumour bed. The patient has clinical no evidence of disease at this time. Tumor recurrence became clinically visible at 10 months after radiotherapy and was histologically confirmed after total laryngectomy (courtesy by Antony A. Mancuso, MD, Gainesville, Florida, USA).
Baseline study, Fig.1 (a)
Baseline study, Fig.1 (b)