Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(03): 661-669
DOI: 10.1055/s-0041-1735921
Pictorial Essay

Imaging Features of Postradiotherapy Changes in Head and Neck Cancers

Anisha Gehani
1   Department of Radiology, Tata Medical Center, Rajarhat, Kolkata, West Bengal, India
,
Saugata Sen 
1   Department of Radiology, Tata Medical Center, Rajarhat, Kolkata, West Bengal, India
,
Sanjoy Chatterjee
2   Department of Radiation Oncology, Tata Medical Center, Rajarhat, Kolkata, West Bengal, India
,
Sumit Mukhopadhyay
1   Department of Radiology, Tata Medical Center, Rajarhat, Kolkata, West Bengal, India
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Radiation therapy is the mainstay in the treatment of head and neck cancers, in addition to surgery and chemotherapy. Expected radiotherapy changes evolving over time may be confused with recurrent tumor. Conversely, even residual or recurrent tumor in the setting of postradiotherapy changes may be difficult to identify clinically or even by radiological imaging. Therefore, it is important to be familiar with the temporal evolution of these changes. The purpose of this pictorial essay is thus to illustrate distinctly the expected radiotherapy changes and radiotherapy-related complications in the head and neck region and to differentiate them from tumor recurrence on routine cross-sectional imaging techniques (computed tomography and magnetic resonance imaging).

Keywords

postradiotherapy changes - head and neck malignancy - head and neck squamous cell carcinoma - radiation complications


Publication History

Article published online:
06 October 2021

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Saito N, Nadgir RN, Nakahira M. et al. Posttreatment CT and MR imaging in head and neck cancer: what the radiologist needs to know. Radiographics 2012; 32 (05) 1261-1282 , discussion 1282–1284
    CrossrefPubMedGoogle Scholar
  • 2 Peter M.Som, Eric M.Genden. The Posttreatment Neck: Clinical and Imaging Considerations. Peter M. Som and Hugh D. Curtin editors. Head and Neck Imaging. 2011. Mosby Elsevier. 5th edition. Volume 2; 2249-2250
    Google Scholar
  • 3 Kim J, Shin ES, Kim JE, Yoon SP, Kim YS. Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer. Radiat Oncol J 2015; 33 (04) 344-349
    CrossrefPubMedGoogle Scholar
  • 4 Benveniste MF, Gomez D, Carter BW. et al. Recognizing radiation therapy-related complications in the chest. Radiographics 2019; 39 (02) 344-366
    CrossrefPubMedGoogle Scholar
  • 5 Alhilali L, Reynolds AR, Fakhran S. Osteoradionecrosis after radiation therapy for head and neck cancer: differentiation from recurrent disease with CT and PET/CT imaging. AJNR Am J Neuroradiol 2014; 35 (07) 1405-1411
    CrossrefPubMedGoogle Scholar
  • 6 Chrcanovic BR, Reher P, Sousa AA, Harris M. Osteoradionecrosis of the jaws–a current overview–part 1: physiopathology and risk and predisposing factors. Oral Maxillofac Surg 2010; 14 (01) 3-16
    CrossrefPubMedGoogle Scholar
  • 7 Glastonbury CM, Parker EE, Hoang JK. The postradiation neck: evaluating response to treatment and recognizing complications. AJR Am J Roentgenol 2010; 195 (02) W164-71
    CrossrefPubMedGoogle Scholar
  • 8 Dassarath M, Yin Z, Chen J, Liu H, Yang K, Wu G. Temporal lobe necrosis: a dwindling entity in a patient with nasopharyngeal cancer after radiation therapy. Head Neck Oncol 2011; 3: 8
    CrossrefPubMedGoogle Scholar
  • 9 Wang Y-XJ, King AD, Zhou H. et al. Evolution of radiation-induced brain injury: MR imaging-based study. Radiology 2010; 254 (01) 210-218
    CrossrefPubMedGoogle Scholar
  • 10 Shah R, Vattoth S, Jacob R. et al. Radiation necrosis in the brain: imaging features and differentiation from tumor recurrence. Radiographics 2012; 32 (05) 1343-1359
    CrossrefPubMedGoogle Scholar
  • 11 Zhao F, Bu L, Zhang W. et al. Herpes simplex encephalitis during radiation therapy in a patient with nasopharyngeal carcinoma. Transl Cancer Res 2017; 6 (06) 1149-1155
    CrossrefGoogle Scholar
  • 12 Sermer DJ, Woodley JL, Thomas CA, Hedlund JA. Herpes simplex encephalitis as a complication of whole-brain radiotherapy: a case report and review of the literature. Case Rep Oncol 2014; 7 (03) 774-779
    CrossrefPubMedGoogle Scholar
  • 13 Dropcho EJ. Neurotoxicity of radiation therapy. Neurol Clin 2010; 28 (01) 217-234
    CrossrefPubMedGoogle Scholar
  • 14 Warade AC, Jha AK, Pattankar S, Desai K. Radiation-induced brachial plexus neuropathy: A review. Neurol India 2019; 67 (suppl): S47-S52
    CrossrefPubMedGoogle Scholar
  • 15 Wilbers J, Kappelle AC, Kessels RP. et al. Long term cerebral and vascular complications after irradiation of the neck in head and neck cancer patients: a prospective cohort study: study rationale and protocol. BMC Neurol 2014; 14: 132
    CrossrefPubMedGoogle Scholar
  • 16 Suárez C, Fernández-Alvarez V, Hamoir M. et al. Carotid blowout syndrome: modern trends in management. Cancer Manag Res 2018; 10: 5617-5628
    CrossrefPubMedGoogle Scholar
  • 17 Choi HS, Jeong BK, Jeong H. et al. Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study. Radiat Oncol J 2016; 34 (01) 26-33
    CrossrefPubMedGoogle Scholar
  • 18 Gujral DM, Shah BN, Chahal NS, Senior R, Harrington KJ, Nutting CM. Clinical features of radiation-induced carotid atherosclerosis. Clin Oncol (R Coll Radiol) 2014; 26 (02) 94-102
    CrossrefPubMedGoogle Scholar
  • 19 Thiagarajan A, Iyer NG. Radiation-induced sarcomas of the head and neck. World J Clin Oncol 2014; 5 (05) 973-981
    CrossrefPubMedGoogle Scholar