Advanced diagnostic techniques of metastatic neck lymph nodes

The development of advanced technologies including computerized tomography devices of new generation (MSCT) and MRI devices has enabled the application of high quality techniques that are used for functional analysis of head and neck tumors. Therefore, the role of conventional CT and MR imaging techniques relating to anatomical domain has been transferred to functional level thus enabling better understanding of biological characteristics of the tumor tissue and better differentiation of benign and malignant neck lymph nodes. Positron emissin tomography (PET) is a functional technique that can detect metastatic neck lesions on the basis of increased glucose metabolism in tumor cells. However, due to poor anatomical resolution some hybrid methods (PET / CT and PET / MR) have been designed that provide morphological and functional information about the tumor tissue and thus are considered to be superior in comparison to conventional PET. Perfusion techniques have proved to be beneficial in the diagnosis of head and neck tumors, especially in the diagnosis of recurrent disease after radiotherapy and for the characterization of the lymph nodes. Diffusion weighted imaging (DWI) is very useful in the diagnosis of malignant lymph nodes smaller than 10 mm that are otherwise difficult to diagnose by means of conventional methods. The paper describes the role of high quality techniques including positron emission tomography PET in combination with CT or MRI (PET / CT and PET / MR) in the diagnostics of metastatic neck lymph nodes, possibilities of perfusion imaging techniques (MSCT / MRI) in the analysis of tumor tissues, as well as possibilities of diffusion MR imaging (DWI-MRI) and MRI with nanoparticles of iron oxide in the differentiation of benign and malignant neck lymph nodes