Imaging features of radiation-induced changes in the abdomen

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• External-beam radiation therapy (EBRT) is a common cancer treatment.
• EBRT can lead to significant changes in abdominal and pelvic organs.
• Radiologists and clinicians need to recognize these post-treatment imaging findings.

Purpose of the Study:

• To describe the spectrum of imaging findings following abdominal and pelvic radiation therapy.
• To highlight early and late radiation-induced changes in various organs.
• To aid in the accurate interpretation of imaging studies in patients treated with EBRT.

Main Methods:

• Review of imaging findings in patients who received EBRT to the abdomen and pelvis.
• Correlation of imaging findings with radiation port and treatment duration.
• Categorization of changes by organ system (liver, gastrointestinal tract, kidneys, bladder, musculoskeletal).

Main Results:

• Liver: low attenuation in radiation port (early), fatty change, fibrosis, contraction (late).
• GI tract: wall thickening, edema (early); strictures, fistulas (late).
• Renal/urinary tract: altered attenuation, ureteral strictures. Bladder: contraction, wall thickening, fistulas.
• Musculoskeletal: growth abnormalities, fatty marrow replacement, osteitis, radiation-induced neoplasms.

Conclusions:

• Radiation therapy induces characteristic, predictable changes in abdominal and pelvic organs.
• Recognizing these changes is crucial for differentiating them from disease recurrence or new pathologies.
• Long-term surveillance may be necessary to monitor for complications such as strictures and neoplasms.