Imaging Techniques for Sinonasal Conditions

Imaging of the sinonasal region underpins diagnosis, treatment planning and follow‐up of conditions ranging from chronic rhinosinusitis to neoplastic and fungal disease. Computed tomography (CT) remains the cornerstone for bony anatomy and air–soft‐tissue interface, while cone‐beam CT offers lower radiation doses and rapid acquisition in outpatient settings. Advanced CT modalities such as dual‐energy and photon‐counting systems enhance material differentiation and spatial resolution, improving detection of mucosal thickening, calcifications and subtle osseous erosions. Magnetic resonance imaging (MRI), including diffusion‐weighted and dynamic contrast‐enhanced sequences, excels in soft‐tissue characterisation and in distinguishing inflammatory changes from neoplastic or fungal involvement. Emerging approaches integrate artificial intelligence for automated segmentation and volumetric analysis, enabling objective assessment of airway patency and mucosal disease burden. Functional imaging with positron emission tomography (PET) and novel radiotracers is under investigation for metabolic profiling of sinonasal tumours. Intraoperative endoscopic modalities, such as narrow‐band imaging, augment standard white‐light endoscopy to visualise mucosal vascular patterns and guide targeted biopsies. Collectively, these techniques inform personalised management, reduce surgical risks and support worldwide efforts to standardise care pathways.

Research from Nature Portfolio

Recent studies have demonstrated that photon‐counting CT yields markedly improved contrast resolution in small sinonasal structures, enabling more accurate detection of early mucosal oedema and subtle osteitic changes. A novel reconstruction algorithm has been shown to reduce artefact in regions adjacent to dental hardware, enhancing diagnostic confidence. Complementary work using deep learning algorithms for CT segmentation has achieved automated delineation of ostiomeatal complexes, facilitating quantitative assessment of volumetric disease and surgical outcome prediction. In parallel, advanced diffusion‐weighted MRI protocols have been optimised to distinguish chronic inflammatory polyps from benign neoplasms without contrast administration, offering a non‐ionising alternative for preoperative characterisation.

Imaging Techniques for Sinonasal Conditions publication trend

The graph below shows the total number of articles in imaging techniques for sinonasal conditions across all publications each year (not limited to Nature Index journals).

Technical terms

Computed tomography (CT): X-ray–based imaging that produces cross-sectional images of bone and soft tissue.

Cone-beam CT: A specialised CT technique offering lower dose and high spatial resolution for facial structures.

Photon-counting CT: An advanced CT detector technology that counts individual X-ray photons to improve contrast and reduce noise.

Dual-energy CT: Imaging using two different X-ray energy spectra to differentiate materials based on their attenuation profiles.

Diffusion-weighted imaging (DWI): MRI sequence sensitive to the movement of water molecules, useful in tissue characterisation.

Dynamic contrast-enhanced MRI: Time-resolved MRI after contrast injection, assessing tissue perfusion and permeability.

Narrow-band imaging (NBI): Endoscopic illumination technique using specific light wavelengths to enhance mucosal microvascular patterns.

Segmentation: Automated or manual delineation of anatomical regions in imaging data for quantitative analysis.