J.A. Castelijns – författare

This volume provides a comprehensive overview of the current state of the art in imaging of the head and neck. The book discusses the role of the standard modalities such as magnetic resonance imaging and computed tomography in diagnosing and staging head and neck cancers and in evaluating the effectiveness of various treatment regimens. In addition, the volume provides extensive insight into the role of emerging and exciting technologies such as positron emission tomography, magnetic resonance spectroscopy, and 3D volume rendering. These new modalities and techniques, in which the authors have extensive experience, promise to influence profoundly the practice of head and neck imaging and will improve the outcome of treatment of diseases of the head and neck in the future.

Historically, the diagnosis of clinical problems in the head and neck has relied on a combination of physical examination and plain film radiography. Although Ziedses des Plantes'' invention of tomography had a major impact on head and neck diagnosis, it remained for the development of CT, MR and modern nuclear medicine to truly revo­ lutionize the specialty. Not only have these new techniques provided better definition of osseous structures and soft tissues but adaptations of these techniques have allowed us to study function as well as anatomy. Utilization of the modern imaging techniques has also provided a springboard for new interventional techniques which promise to re­ define the treatment of head and neck problems. As a consequence there are now many highly specific diagnostic and therapeutic applications of these new technologies that are not familiar to the average practicing radiologist or otolaryngologist. Drs. Mukherji and Castelijns have made an important contribution by bringing together a group of outstanding authors from around the world who explain in detail how these new techniques can be applied and what their impact is on patient care. Included among the authors are both radiologists and oto­ laryngologists. The volume will serve as a practical, easy reference guide to physicians when unusual problems are encountered in this somewhat unfamiliar area of patient of particular value to the radiologist who deals with these care. The volume should be new modalities on a day-to-day basis.

MRI is assuming a dominant role in imaging of the larynx. Its superior soft tissue contrast resolution makes it ideal for differentiating invasion of tumors of the larynx from normal or more sharply circumscribed configuration of most of the benign lesions. Over ten years ago CT made a major impact on laryngeal examination because it was the first time that Radiologists were beginning to look at submucosal disease. All of the previous examinations duplicated the infor­ mation that was available to the clinician via direct and in-direct laryngo­ scopy. With the advent of rigid and flexible endoscopes, clinical examination became sufficiently precise that there was little need to perform studies such as laryngography which merely showed surface anatomy. The status of deep structures by these techniques was implied based on function. Fortunately laryngography is now behind us together with all of the gagging and contrast reactions which we would all like to forget. CT is still an excellent method of examining the larynx but it is unfortunately limited to the axial plane. With presently available CT techniques motion deteriorates any reformatting in sagittal or coronal projections. The latter two planes are extremely helpful in delineating the vertical extent of submucosal spreads. MRI has proven extremely valuable by producing all three basic projections, plus superior soft tissue contrast. Although motion artifacts still degrade the images in some patients, newer pulsing sequences that permit faster scanning are elimi­ nating most of these problems.