Download PDF
CC BY 4.0 · Indian J Med Paediatr Oncol 2023; 44(02): 175-180
DOI: 10.1055/s-0042-1760309
Review Article

Imaging Recommendations for Diagnosis, Staging, and Management of Nasopharynx Carcinoma

Chirag Kamal Ahuja
1   Division of Neuroimaging and Interventional Neuroradiology, Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Vivek Agarwal
2   Division of Neuro and Vascular Intervention, Department of Neurology, Christian Medical College and Hospital, Ludhiana, Punjab, India
,
Chirag Jain 
3   Department of Radiodiagnosis, VMMC and Safdarjung Hospital, New Delhi, India
,
Sameer Vyas
1   Division of Neuroimaging and Interventional Neuroradiology, Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Jyoti Kumar 
4   Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India
,
Paramjeet Singh
1   Division of Neuroimaging and Interventional Neuroradiology, Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Nasopharyngeal carcinoma (NPC) is an epithelial carcinoma originating from lining of the nasopharyngeal mucosa usually at the fossa of Rosenmuller (pharyngeal recess). An early detection on endoscopy can be rewarding, however, often difficult as the tumor at the pharyngeal recess is hidden from the endoscopic view. Magnetic resonance imaging and positron emission tomography–computed tomography form the backbone of detection and spread of the carcinoma into local and distant regions. These modalities help further characterize the precise locoregional infiltration and lymph nodal involvement which aids in the planning of the surgery/chemoradiotherapy. They also help in the follow-up evaluation and further management strategies. Many research and treatment groups namely American Joint Committee on Cancer, National Comprehensive Cancer Network, American Society of Clinical Oncology, American College of Radiology, Radiological Society of North America, European Society of Radiology (iGuide), Indian Radiological & Imaging Association/Indian College of Radiology and Imaging, National Cancer Grid, etc. have devised guidelines for the optimal assessment and treatment of NPC. The present document aims at providing a comprehensive review of the clinicoradiological recommendations for the diagnosis and management of NPC based on these guidelines as well as personalized experience of the contributors.

Keywords

nasopharyngeal carcinoma - diagnosis - staging - magnetic resonance imaging - computed tomography

Supplementary Material



Publication History

Article published online:
01 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Abdel Khalek Abdel Razek A, King A. MRI and CT of nasopharyngeal carcinoma. AJR Am J Roentgenol 2012; 198 (01) 11-18
    CrossrefPubMedGoogle Scholar
  • 2 Chen Y-P, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J. Nasopharyngeal carcinoma. Lancet 2019; 394 (10192): 64-80
    CrossrefPubMedGoogle Scholar
  • 3 Raghupathy R, Hui EP, Chan AT. Epstein-Barr virus as a paradigm in nasopharyngeal cancer: from lab to clinic. Am Soc Clin Oncol Educ Book 2014; 34 (01) 149-153
    CrossrefPubMedGoogle Scholar
  • 4 Ung A, Chen CJ, Levine PH. et al. Familial and sporadic cases of nasopharyngeal carcinoma in Taiwan. Anticancer Res 1999; 19 (1B): 661-665
    Google Scholar
  • 5 Chua MLK, Wee JTS, Hui EP, Chan ATC. Nasopharyngeal carcinoma. Lancet 2016; 387 (10022): 1012-1024
    CrossrefPubMedGoogle Scholar
  • 6 Hildesheim A, Apple RJ, Chen CJ. et al. Association of HLA class I and II alleles and extended haplotypes with nasopharyngeal carcinoma in Taiwan. J Natl Cancer Inst 2002; 94 (23) 1780-1789
    CrossrefPubMedGoogle Scholar
  • 7 Barnes L, Eveson JW, Sidransky D, Reichart P. eds. Pathology and Genetics of Head and Neck Tumours. Geneva, Switzerland: : IARC; 2005
    Google Scholar
  • 8 Leung SF, Zee B, Ma BB. et al. Plasma Epstein-Barr viral deoxyribonucleic acid quantitation complements tumor-node-metastasis staging prognostication in nasopharyngeal carcinoma. J Clin Oncol 2006; 24 (34) 5414-5418
    CrossrefPubMedGoogle Scholar
  • 9 Lee AWM, Lydiatt WM, Colevas AD. et al. Nasopharynx. In: Amin MB. ed. AJCC Cancer Staging Manual. 8th ed. New York: Springer; 2017: 103
    Google Scholar
  • 10 Saba NF, Salama JK, Beitler JJ. et al; Expert Panel on Radiation Oncology-Head and Neck Cancer. ACR appropriateness criteria® for nasopharyngeal carcinoma. Head Neck 2016; 38 (07) 979-986
    CrossrefPubMedGoogle Scholar
  • 11 NCG Guidelines Manual. Accessed March 20, 2022 https://tmc.gov.in/ncg/index.php/guidelines/draft-guidelines-2020
  • 12 Colevas AD, Yom SS, Pfister DG. et al. NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018. J Natl Compr Canc Netw 2018; 16 (05) 479-490
    CrossrefPubMedGoogle Scholar
  • 13 NCCN Guidelines for patients Nasopharyngeal Cancer. Accessed March 20, 2022 https://www.nccn.org/patients/guidelines/content/PDF/hn-nasopharynx-patient.pdf
  • 14 Chan KCA, Hung ECW, Woo JKS. et al. Early detection of nasopharyngeal carcinoma by plasma Epstein-Barr virus DNA analysis in a surveillance program. Cancer 2013; 119 (10) 1838-1844
    CrossrefPubMedGoogle Scholar
  • 15 Lee AWM, Ng WT, Chan LLK. et al. Evolution of treatment for nasopharyngeal cancer–success and setback in the intensity-modulated radiotherapy era. Radiother Oncol 2014; 110 (03) 377-384
    CrossrefPubMedGoogle Scholar
  • 16 King AD, Vlantis AC, Bhatia KSS. et al. Primary nasopharyngeal carcinoma: diagnostic accuracy of MR imaging versus that of endoscopy and endoscopic biopsy. Radiology 2011; 258 (02) 531-537
    CrossrefPubMedGoogle Scholar
  • 17 King AD, Lam WW, Leung SF, Chan YL, Teo P, Metreweli C. MRI of local disease in nasopharyngeal carcinoma: tumour extent vs tumour stage. Br J Radiol 1999; 72 (860) 734-741
    CrossrefPubMedGoogle Scholar
  • 18 Chong VF, Fan YF, Khoo JB. Nasopharyngeal carcinoma with intracranial spread: CT and MR characteristics. J Comput Assist Tomogr 1996; 20 (04) 563-569
    CrossrefPubMedGoogle Scholar
  • 19 King AD, Vlantis AC, Tsang RKY. et al. Magnetic resonance imaging for the detection of nasopharyngeal carcinoma. AJNR Am J Neuroradiol 2006; 27 (06) 1288-1291
    PubMedGoogle Scholar
  • 20 King AD, Ahuja AT, Leung SF. et al. Neck node metastases from nasopharyngeal carcinoma: MR imaging of patterns of disease. Head Neck 2000; 22 (03) 275-281
    CrossrefPubMedGoogle Scholar
  • 21 Ng SH, Chang JT, Chan SC. et al. Nodal metastases of nasopharyngeal carcinoma: patterns of disease on MRI and FDG PET. Eur J Nucl Med Mol Imaging 2004; 31 (08) 1073-1080
    PubMedGoogle Scholar
  • 22 Chong VF, Fan YF, Khoo JB. Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. Eur J Radiol 1995; 21 (02) 100-105
    CrossrefPubMedGoogle Scholar
  • 23 Som PM, Brandwein MS. Lymph nodes. In: Som PM, Curtin HD. eds. Head and Neck Imaging. 4th ed. Vol. 2. Missouri, USA: : Mosby Inc; 2003: 1910-1911
    Google Scholar
  • 24 Som PM. Detection of metastasis in cervical lymph nodes: CT and MR criteria and differential diagnosis. AJR Am J Roentgenol 1992; 158 (05) 961-969
    CrossrefPubMedGoogle Scholar
  • 25 King AD, Tse GM, Ahuja AT. et al. Necrosis in metastatic neck nodes: diagnostic accuracy of CT, MR imaging, and US. Radiology 2004; 230 (03) 720-726
    CrossrefPubMedGoogle Scholar
  • 26 Teo PM, Kwan WH, Lee WY, Leung SF, Johnson PJ. Prognosticators determining survival subsequent to distant metastasis from nasopharyngeal carcinoma. Cancer 1996; 77 (12) 2423-2431
    CrossrefPubMedGoogle Scholar
  • 27 Chang JT, Chan SC, Yen TC. et al. Nasopharyngeal carcinoma staging by (18)F-fluorodeoxyglucose positron emission tomography. Int J Radiat Oncol Biol Phys 2005; 62 (02) 501-507
    CrossrefPubMedGoogle Scholar
  • 28 Pfister DG, Spencer S, Adelstein D. et al. Head and Neck Cancers, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020; 18 (07) 873-898
    CrossrefPubMedGoogle Scholar
  • 29 Comoretto M, Balestreri L, Borsatti E, Cimitan M, Franchin G, Lise M. Detection and restaging of residual and/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy: comparison of MR imaging and FDG PET/CT. Radiology 2008; 249 (01) 203-211
    CrossrefPubMedGoogle Scholar
  • 30 Offiah C, Hall E. Post-treatment imaging appearances in head and neck cancer patients. Clin Radiol 2011; 66 (01) 13-24
    CrossrefPubMedGoogle Scholar
  • 31 Chong VF, Fan YF. Meningeal infiltration in recurrent nasopharyngeal carcinoma. Australas Radiol 2000; 44 (01) 23-27
    CrossrefPubMedGoogle Scholar