New developments in medical imaging: The potential and clinical applications in otolaryngology and head and neck disease

Abstract

Medical imaging techniques have been evolving rapidly. Both acquisition and reconstruction of data are far less time-consuming, MRI units as high as 7 Tesla are in clinical use and new techniques, for example diffusion weighted MRI, are becoming standard of care for varying clinical indications. In this thesis, I evaluated its potential and clinical applications in otolaryngology and head and neck disease. Imaging is used both in diagnostics and follow-up. Diffusion weighted MRI has a place in daily practice for the diagnosis of middle ear cholesteatoma in selected primary cases and in postoperative cases, in some of which a second look operation can be avoided. For middle and inner ear pathology, the use of 7 Tesla MRI does not have a benefit yet in comparison with the 1.5 and 3 Tesla. This also applies for small laryngeal carcinoma, in which 7 Tesla is not feasible yet and 3 Tesla MRI is not yet superior to CT. However we do see clinical potential in 3 Tesla MRI for small laryngeal carcinoma with further technical development of this technique. FDG-PET/CT in primary head and neck cancer is complementary to routine diagnostics, also for staging of the neck. In case of pathological lymph nodes on PET and/or CT scan, in most cases a high nodal target volume is given.