Accurate anatomical localization in interpretation of PET/CT imaging for patients with head and neck malignancies

Learning Objectives To better understand the spaces related to suprahyoid neck, levels of cervical lymph nodes and the pattern of lymphatic drainage in patients with head and neck tumors.Head and neck cancer accounts for 3% to 4% of all malignancies with approximately 65,000 new cases detected each year. To facilitate surgical and radiation treatment planning, accurate staging and/or restaging is required. PET/CT has been proven to have higher sensitivity and specificity than CT, MRI or PET alone for the detection of cervical lymph node and/or distant metastasis. Due to the complexity of the anatomy of the head and neck, the accuracy in localization of head and neck malignancies in PET/CT cases is varied amongst different readers. Therefore, mastering the anatomy is very important for nuclear medicine physicians in order to precisely interpret the head and neck tumors in PET/CT studies.

Summary: It is very important for nuclear medicine physicians to master the anatomy of the head and neck in order to accurately interpret PET/CT studies. This paper will describe the head and neck anatomy related to PET/CT studies, in particular, the spaces of suprahyoid, classification of the levels of cervical lymph nodes and cervical lymphatic drainage patterns.