Imaging of pediatric head and neck tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee/ASPNR White Paper

Abramson ZR, Nagaraj UD, Lai LM, Liu CC, Schroeder JW, Khanna PC, Chuang NA, Strauss S, Gomez G, Clarke R, Singh S, Choudhri AF, Whitehead MT. Imaging of pediatric head and neck tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee/ASPNR White Paper. Pediatr Blood Cancer. 2023 Jun;70 Suppl 4(Suppl 4):e30151. doi: 10.1002/pbc.30151. Epub 2022 Dec 22. PubMed PMID: 36546312; PubMed Central PMCID: PMC10644272.

Head and neck cancer comprises approximately 12% of all childhood malignancies.1 Common head and neck tumors include those which can occur in other regions of the body, such as neuroblastoma, rhabdomyosarcoma, lymphoma, Ewing Sarcoma and osteosarcoma, as well as those arising in tissues specific to the head and neck, such as salivary gland malignancies, nasopharyngeal carcinoma, and odontogenic neoplasms.1 The presenting signs and symptoms of pediatric head and neck tumors are variable. However, most head and neck tumors come to attention due to the presence of a visible or palpable mass, or a functional deficit that varies by location, such as epistaxis, difficulty swallowing, and malocclusion. While there are a variety of staging systems for head and neck tumors, common themes including size, location, and trans-spatial involvement, and nodal and distant metastatic disease are important across diagnoses. While staging may be tumor-specific, there is a growing trend to increase the uniformity of techniques used to assess outcomes and response to therapy. Both tumor staging and outcomes assessment require high spatial and contrast resolution, shaping imaging recommendations.