Imaging of Nasopharyngeal Carcinoma ANNALS（鼻咽癌年报的成像）.pdfVIP

Imaging of NPC—Julian Goh and Keith Lim 809 Risk Adjustment for Comparing Health Outcomes—Yew Yoong Ding Review Article Imaging of Nasopharyngeal Carcinoma Julian Goh,1 2 MBBS, FRCR , Keith Lim, MBBS, FRANZCR Abstract 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 and neck. Magnetic resonance imaging (MRI) is now the preferred imaging modality in the assessment and staging of NPC, especially in relation to its superior soft tissue contrast, ability to demonstrate perineural tumour spread, parapharyngeal space, bone marrow involvement and its ability to show the involvement of adjacent structures, such as the adjacent paranasal sinuses and intracranial extension. An understanding of its patterns of spread and the criteria used in the AJCC TNM staging system is important to relay the relevant information to the referring clinician, so that appropriate treatment planning decisions may be made. In this article, the various features of NPC that are pertinent to staging and treatment planning will be discussed, inclusive of locoregional spread, nodal involvement and metastatic disease. Ann Acad Med Singapore 2009;38:809-16 Key words: Magnetic resonance imaging, Staging Introduction causative factor, while the presence of HLA A2 and BSin2, Nas