Cross-sectional imaging in non-melanoma skin cancer of the head and neck.

Aim: To investigate in head and neck non-melanoma skin cancers (NMSCs) the accuracy of cross-sectional imaging for detection of local tumour extent, recurrent tumour and prediction of patient outcome.
Methods: This retrospective study included 33 NMSC patients (22 men, 11 women, median age 69 years) with 8 primary and 25 suspected recurrent tumours. The findings of magnetic resonance imaging (MRI) and computed tomography (CT) were compared with histopathology, and accuracy of MRI or CT in detecting local recurrence was determined. Extent of disease on imaging was compared with patient outcome assessed by clinical follow-up to a mean of 26.4 months.
Results: Lesions were identified in 29 patients, whose mean disease-free survival (DFS) was 25.5 months. In 4 of these cases, where imaging showed no invasion of deep structures, DFS was 56 months. In the other 25 cases DFS was 20.6 months, irrespective of treatment but varying with site of involvement. Of 19 patients treated with surgery, imaging of 16 showed deep invasion, which was confirmed at histology in 15 (93.7% accuracy), and 3 had superficial tumours on imaging all confirmed by histology (100% accuracy). Imaging accuracy for identifying recurrent tumour was 96% (24 of 25 patients).
Conclusion: In NMSC, cross-sectional imaging accurately identifies tumour extent and local recurrence. The extent of disease and invasion of deeper structures predicts patient outcome.