CT/MRI Neck
CT/MRIVaries
EDOutpatient
All imaging requests must be justified by an IR(ME)R practitioner (radiologist or radiographer)Head and neck cancer 2WW
— ANY of the following
- Persistent unexplained hoarseness ≥45 yearsNICE NG12
- Unexplained oral ulceration >3 weeksNICE NG12
- Unexplained thyroid lumpNICE NG12
- Unexplained persistent neck lumpNICE NG12
- CT neck with IV contrast standard initial imaging
MRI neck preferred for
— ANY of the following
- Primary tumour delineation in oral cavity, oropharynx, nasopharynxNICE NG36 Rec 1.2.7
- Perineural spread assessment
- FDG PET-CT first-line for metastatic nodal SCC of unknown primaryNICE NG36 Rec 1.2.3
Salivary glands
USS mandatory FIRST for palpable salivary mass; MRI/CT for further characterisation
- USS mandatory FIRST for palpable salivary massBAHNO/ENT-UK
- MRI for: malignant lesions, deep lobe parotid, perineural spread
- CT secondary (bone erosion, staging)
Deep neck space infection — ED
— ANY of the following
- Contrast-enhanced CT gold standard (~95% sensitivity for abscess)
Temporal bone / vestibular schwannoma
— ANY of the following
- CT temporal bones (HRCT) for cholesteatoma, conductive hearing loss
- MRI IAM for vestibular schwannoma: asymmetric SNHL ≥15 dB at 2 adjacent frequenciesNICE NG98 Rec 1.3.2
Notes
Information
NHS England Timed Diagnostic Pathway — imaging within 7 calendar days
Information
USS mandatory first-line for salivary gland masses
BAHNO/ENT-UKLocal preference
MRI preferred for tumour delineation; CT for bony assessment
Change Log
v2.02026-03-08New protocol — comprehensive head and neck imaging