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Complications of radiation therapy: CT evaluation
D A Bluemke1, E K Fishman, J E Kuhlman
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Summary
Computed tomography (CT) detects radiation-induced injuries after cancer therapy. Characteristic CT findings, radiation details, and time since therapy aid diagnosis, guiding further evaluation for unexplained findings or recurrent disease.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Radiation therapy is a cornerstone of cancer treatment.
- Computed tomography (CT) is frequently used to assess treatment efficacy and monitor patients post-radiation.
- Radiation therapy can lead to various injuries in normal tissues surrounding the treatment area.
Purpose of the Study:
- To describe the spectrum of radiation-induced injuries detectable by CT.
- To outline the diagnostic approach for identifying these injuries.
- To differentiate radiation effects from recurrent malignancy.
Main Methods:
- Review of CT imaging findings in patients who have undergone radiation therapy.
- Correlation of imaging findings with clinical data, including radiation port, dose, and time interval.
- Analysis of characteristic and rare CT manifestations of radiation injury.
Main Results:
- Common CT findings include pneumonitis, calcified lymph nodes, enteritis, hepatitis, cystitis, nephritis, osteitis, and insufficiency fractures.
- Rare complications identified on CT encompass spontaneous pneumothorax, thymic cysts, vascular calcifications, and osseous sarcomas.
- Diagnosis is typically achievable through characteristic CT appearances combined with knowledge of radiation parameters.
Conclusions:
- CT plays a crucial role in identifying and evaluating radiation-induced injuries.
- Understanding typical and rare CT findings aids in accurate diagnosis.
- Unexplained CT findings or those suspicious for recurrence warrant further investigation.