Hi,
There is a role of MRI in head and neck cancers apart from Npx.
The main advantage of MRI over CT scan is the superior soft tissue delineation. The obvious downside is the expense, scanning time, inability to do RT planning.
I believe MRI is useful in the oropharyngeal malignancies, especially so in BOT lesion. CT has poor visualisation in this area and MRI images can help to see the infiltration into the tongue muscles. In patients treated with IMRT, where the margins are conservative, I always prefer to have MRI done pre RT planning. MRI in this particular setting is much better that PET/CT also. In tonsillar ca, it helps to contour primary, especially the lateral extent.
I think the role in laryngeal malignancies is limited as CT scan or PET/CT can give good images.
Use of spectroscopy, perfusion scan is more for differentiating between recurrence and post RT changes. I dont think it will add any extra clinically relevant information. DW and DCE data can be integrated to know the functional aspect of the tumour but the evidence is still building on that.
Prasad
