Chemotherapy-induced bowel ischemia: diagnostic imaging overview

Area of Science:

• Oncology
• Radiology
• Gastroenterology

Background:

• Multimodal cancer therapies, including chemotherapy and immunotherapy, are increasingly used.
• These treatments can cause significant organ toxicity, particularly in the gastrointestinal tract.
• Bowel toxicity presents heterogeneously, ranging from mild symptoms to severe complications like ischemia.

Purpose of the Study:

• To describe the main characteristics of drug-related intestinal vascular damage.
• To illustrate the radiological findings associated with these vascular alterations.
• To emphasize the importance of recognizing these toxicities in oncologic imaging.

Main Methods:

• Review of radiological findings in cancer patients undergoing drug therapies.
• Correlation of imaging features with known mechanisms of chemotherapy and immunotherapy.
• Analysis of clinical presentations associated with identified vascular damage.

Main Results:

• Drug-induced bowel toxicity can manifest as vascular damage in intestinal vessels and submucosal microvessels.
• Radiological imaging reveals specific alterations related to these vascular injuries.
• Understanding these patterns is crucial for differentiating treatment effects from disease progression.

Conclusions:

• Radiologists must be aware of the potential for drug-related intestinal vascular damage in cancer patients.
• Familiarity with imaging features of chemotherapy and immunotherapy toxicity is essential for accurate interpretation.
• This knowledge aids in managing patients receiving complex oncologic treatments.