Head & Neck CT

What it does

Head & Neck CT covers the ENT family of CT protocols: the contrast-enhanced neck CT, the paranasal sinus CT and the high-resolution temporal-bone CT. Upload any of them; the run identifies the protocol and reads the sections that protocol supports, so a sinus CT returns a Lund-Mackay score and a neck CT returns nodes, abscesses and tumour findings.

On a contrast neck CT the run maps lymph nodes to levels I–VII with short axis, necrosis and extranodal-extension signs, detects deep neck abscesses and a primary tumour, and measures the upper airway. On a sinus CT it grades opacification of every sinus and the ostiomeatal complex. On a temporal-bone CT it reads the ossicles, otic capsule, scutum and semicircular canals for erosion, cholesteatoma signs and dehiscence. Facial fractures are read by the Head CT model, not here.

Intended use

Decision support for the clinician who reads or acts on a head and neck CT: the ENT surgeon planning sinus surgery, the emergency physician with a febrile patient and neck swelling at night, the oncologist following treated cancer. Every finding carries its measurements.

Who it is for

Head and neck radiologists, ENT and maxillofacial surgeons, radiation and medical oncologists, and emergency physicians. Developers use the run to bring structured nodal levels and sinus scores into an ENT clinic system or a tumour-board tool.

Accepted input

• Protocols: contrast-enhanced neck CT, sinus CT or temporal-bone HRCT, as DICOM CT series. The protocol, intravenous contrast and anatomical coverage are detected from the images, not from the series description.
• A prior neck CT in prior_files when post-treatment change is in question.

Requirements

Requirement	Why
Intravenous contrast for neck sections	Node necrosis, abscess rim and tumour enhancement need it
Neck or chest coverage for the airway	Lumen area and stenosis length are measured along the covered airway
Sinus CT covering all paranasal sinuses	Lund-Mackay sums every sinus on both sides
Thin bone-kernel reconstruction for temporal bone	Ossicles and canal walls are sub-millimetre structures

Dental amalgam streaks and swallowing motion are reported as quality flags.

Optional context

The indication (infection, staging, post-treatment surveillance, chronic rhinosinusitis, hearing loss) and the treatment history go in clinical_context. For a treated neck, findings are framed in NI-RADS post-treatment terms.

The result

A sectioned JSON result with findings, measurements and classifications, plus DICOM objects for the masks.

Section	Content
Cervical lymph nodes	Nodes per level I–VII: short axis, necrosis, extranodal-extension signs and a Node-RADS score
Primary tumour	Oral cavity, oropharynx, larynx or nasopharynx tumour: segmentation, size and invasion flags
Deep neck abscess	Peritonsillar, parapharyngeal or retropharyngeal abscess: size, airway compromise, mediastinal extension
Upper airway	Lumen segmentation, minimal cross-sectional area, stenosis length and extrinsic compression
Lund-Mackay sinus score	Opacification 0, 1 or 2 per sinus, ostiomeatal-complex patency, total 0–24
Temporal bone	Ossicular chain and otic capsule: scutum erosion, cholesteatoma signs, canal dehiscence
Draft report	Opt-in (options.report): an English narrative that interprets the result for the reader (findings, impression, limitations); every number is checked against the findings

Standards

• DICOM: SR TID 1500 Measurement Report for node, tumour and airway measurements; SEG for tumour and node masks; Encapsulated PDF and FHIR DiagnosticReport.
• Reporting systems: Node-RADS 1.0 for nodal risk, the Lund-Mackay staging system for sinus CT, NI-RADS for the post-treatment neck.

Scoring notes

On each side, the maxillary, anterior ethmoid, posterior ethmoid, sphenoid and frontal sinuses are graded 0 (clear), 1 (partial) or 2 (total opacification), and the ostiomeatal complex 0 (patent) or 2 (obstructed). Both sides together give a Lund-Mackay total from 0 to 24. Every node is assigned to one of levels I–VII and measured in short axis, then scored with Node-RADS 1.0.