Imaging of squamous cell carcinoma

Imaging of squamous cell carcinoma (SCC) can be a challenging task and usually requires a combination of several imaging modalities that provide different complimentary information about tumor morphology and characterization, as well as indications about tumor prognosis and treatment planning. In this chapter, the role of the various imaging techniques (such as Computed Tomography [CT], Magnetic Resonance Imaging [MRI], and Positron Emission Tomography [PET]) available for the evaluation of head-and-neck SCC will be illustrated, and imaging findings will be discussed along with their correlation with pathologic features. To this purpose, modern multidetector CT technology allows an accurate assessment of tumor extent and morphology owing to its excellent spatial resolution and the possibility to perform 2D and 3D reconstructions of native images with voxel isotropy, while MRI plays a major role for tumor characterization due to its superior contrast resolution and its multiparametric nature. On the other hand, PET can provide metabolic data that are useful for detection of disease recurrence after treatment and lymph node and/or distant dissemination. Particular attention will also be paid to emerging imaging modalities, such as CT perfusion, that can provide functional information about tumor vascularity and represent promising tools for noninvasive evaluation of tumor prognosis before chemo-radiation therapy, as well as of early disease recurrence after treatment.