Imaging of the Posttreatment Head and Neck: Expected Findings and Potential Complications

Radiol Imaging Cancer. 2024 Jan;6(1):e230155. doi: 10.1148/rycan.230155.

Abstract

Interpretation of posttreatment imaging findings in patients with head and neck cancer can pose a substantial challenge. Malignancies in this region are often managed through surgery, radiation therapy, chemotherapy, and newer approaches like immunotherapy. After treatment, patients may experience various expected changes, including mucositis, soft-tissue inflammation, laryngeal edema, and salivary gland inflammation. Imaging techniques such as CT, MRI, and PET scans help differentiate these changes from tumor recurrence. Complications such as osteoradionecrosis, chondroradionecrosis, and radiation-induced vasculopathy can arise because of radiation effects. Radiation-induced malignancies may occur in the delayed setting. This review article emphasizes the importance of posttreatment surveillance imaging to ensure proper care of patients with head and neck cancer and highlights the complexities in distinguishing between expected treatment effects and potential complications. Keywords: CT, MR Imaging, Radiation Therapy, Ear/Nose/Throat, Head/Neck, Nervous-Peripheral, Bone Marrow, Calvarium, Carotid Arteries, Jaw, Face, Larynx © RSNA, 2024.

Keywords: Bone Marrow; CT; Calvarium; Carotid Arteries; Ear/Nose/Throat; Face; Head/Neck; Jaw; Larynx; MR Imaging; Nervous-Peripheral; Radiation Therapy.

Publication types

  • Review

MeSH terms

  • Head and Neck Neoplasms* / diagnostic imaging
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Neoplasm Recurrence, Local
  • Osteoradionecrosis*
  • Positron-Emission Tomography / methods
  • Radiation Injuries* / diagnostic imaging
  • Radiation Injuries* / etiology
  • Radiation Injuries* / therapy