Fig. 15.

An 81-year old male patient with a hypopharyngeal carcinoma from the piriform sinus, presented 6 months after chemoradiation to evaluate therapy response. The initial CT with the presence of a bilateral tumor of the piriform sinus and massive (postoperative) subcutaneous emphysema (a). A mixed DECT at one year (b) was made for evaluation of therapy effect and exclusion of residual tumor. Bilateral swelling is present, without clear enhancement at mixed imaging. At the iodine overlay images (c), no increased iodine uptake was present; benign posttreatment changes without residual or recurrent tumor were concluded