Advances in image guided diagnostic applications for lymph node staging in head and neck cancer

In head and neck cancer, lymph node metastases are critical for treatment planning, but standard imaging often misses small or subclinical deposits. This thesis investigated two advanced approaches for more precise nodal assessment: USPIO-enhanced MRI and the sentinel lymph node (SLN) procedure.

USPIO-enhanced MRI allows high-resolution functional imaging, detecting small metastases with high sensitivity and negative predictive value, improving pre-treatment nodal staging. The SLN procedure was adapted for laryngeal and pharyngeal cancers using office-based endoscopic radioactive tracer injections, proving safe, feasible, and fast without general anesthesia.

These techniques support individualized treatment, potentially reducing the need for extensive neck surgery or irradiation while maintaining oncological safety.