Spectrum of soft tissue and cartilage changes following radiation therapy (XRT) for head and neck tumors
Radiation effects
Acute-subacute: Diffuse edema and inflammation
Chronic: Evolves to fibrosis and atrophy
Radiation complications
Persistent laryngeal edema ≥ 6 months
Laryngeal chondronecrosis
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Glastonbury CM et al: Head and neck squamous cell cancer: approach to staging and surveillance. In Hodler J et al: Diseases of the Brain, Head and Neck, Spine 2020-2023: Diagnostic Imaging. Springer, 2020
Gore A et al: Posttreatment imaging in patients with head and neck cancer without clinical evidence of recurrence: should surveillance imaging extend beyond 6 months? AJNR Am J Neuroradiol. 41(7):1238-44, 2020
Strauss SB et al: Best practices for post-treatment surveillance imaging in head and neck cancer: application of the neck imaging reporting and data system (NI-RADS). AJR Am J Roentgenol. 216(6):1438-51, 2020
Yang L et al: Nasopharyngeal granulomatous mass after radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx. 43(3):330-5, 2016
Alhilali L et al: Osteoradionecrosis after radiation therapy for head and neck cancer: differentiation from recurrent disease with CT and PET/CT imaging. AJNR Am J Neuroradiol. 35(7):1405-11, 2014
Saito N et al: Posttreatment CT and MR imaging in head and neck cancer: what the radiologist needs to know. Radiographics. 32(5):1261-82; discussion 1282-4, 2012
Berg EE et al: Pathologic effects of external-beam irradiation on human vocal folds. Ann Otol Rhinol Laryngol. 120(11):748-54, 2011
Bisdas S et al: Perfusion CT in squamous cell carcinoma of the upper aerodigestive tract: long-term predictive value of baseline perfusion CT measurements. AJNR Am J Neuroradiol. 31(3):576-81, 2010
Faggioni L et al: CT perfusion of head and neck tumors: how we do it. AJR Am J Roentgenol. 194(1):62-9, 2010
Glastonbury CM et al: The postradiation neck: evaluating response to treatment and recognizing complications. AJR Am J Roentgenol. 195(2):W164-71, 2010
Yoo JS et al: Osteoradionecrosis of the hyoid bone: imaging findings. AJNR Am J Neuroradiol. 31(4):761-6, 2010
Debnam JM et al: Benign ulceration as a manifestation of soft tissue radiation necrosis: imaging findings. AJNR Am J Neuroradiol. 29(3):558-62, 2008
Abdel Razek AA et al: Role of diffusion-weighted echo-planar MR imaging in differentiation of residual or recurrent head and neck tumors and posttreatment changes. AJNR Am J Neuroradiol. 28(6):1146-52, 2007
Sanguineti G et al: Dosimetric predictors of laryngeal edema. Int J Radiat Oncol Biol Phys. 68(3):741-9, 2007
Mukherji SK et al: Imaging of the post-treatment larynx. Eur J Radiol. 44(2):108-19, 2002
Nömayr A et al: MRI appearance of radiation-induced changes of normal cervical tissues. Eur Radiol. 11(9):1807-17, 2001
Filntisis GA et al: Laryngeal radionecrosis and hyperbaric oxygen therapy: report of 18 cases and review of the literature. Ann Otol Rhinol Laryngol. 109(6):554-62, 2000
Baron-Hay S et al: Life threatening laryngeal toxicity following treatment with combined chemoradiotherapy for nasopharyngeal cancer: a case report with review of the literature. Ann Oncol. 10(9):1109-12, 1999
De Vuysere S et al: CT findings in laryngeal chondroradionecrosis. JBR-BTR. 82(1):16-8, 1999
Fitzgerald PJ et al: Delayed radionecrosis of the larynx. Am J Otolaryngol. 20(4):245-9, 1999
Hermans R et al: CT findings in chondroradionecrosis of the larynx. AJNR Am J Neuroradiol. 19(4):711-8, 1998
Schmalfuss IM et al: Arytenoid cartilage sclerosis: normal variations and clinical significance. AJNR Am J Neuroradiol. 19(4):719-22, 1998
Greven KM et al: Can positron emission tomography distinguish tumor recurrence from irradiation sequelae in patients treated for larynx cancer? Cancer J Sci Am. 3(6):353-7, 1997
Greven KM et al: Positron emission tomography of patients with head and neck carcinoma before and after high dose irradiation. Cancer. 74(4):1355-9, 1994
Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part I. Expected changes. Radiology. 193(1):141-8, 1994
Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part II. Primary site response. Radiology. 193(1):149-54, 1994
Tart RP et al: Value of laryngeal cartilage sclerosis as a predictor of outcome in patients with stage T3 glottic cancer treated with radiation therapy. Radiology. 192(2):567-70, 1994
Tartaglino LM et al: Imaging of radiation changes in the head and neck. Semin Roentgenol. 29(1):81-91, 1994
Briggs RJ et al: Laryngeal imaging by computerized tomography and magnetic resonance following radiation therapy: a need for caution. J Laryngol Otol. 107(6):565-8, 1993
Bronstein AD et al: Soft-tissue changes after head and neck radiation: CT findings. AJNR Am J Neuroradiol. 10(1):171-5, 1989
Related Anatomy
Loading...
Related Differential Diagnoses
Loading...
References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
Spectrum of soft tissue and cartilage changes following radiation therapy (XRT) for head and neck tumors
Radiation effects
Acute-subacute: Diffuse edema and inflammation
Chronic: Evolves to fibrosis and atrophy
Radiation complications
Persistent laryngeal edema ≥ 6 months
Laryngeal chondronecrosis
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Glastonbury CM et al: Head and neck squamous cell cancer: approach to staging and surveillance. In Hodler J et al: Diseases of the Brain, Head and Neck, Spine 2020-2023: Diagnostic Imaging. Springer, 2020
Gore A et al: Posttreatment imaging in patients with head and neck cancer without clinical evidence of recurrence: should surveillance imaging extend beyond 6 months? AJNR Am J Neuroradiol. 41(7):1238-44, 2020
Strauss SB et al: Best practices for post-treatment surveillance imaging in head and neck cancer: application of the neck imaging reporting and data system (NI-RADS). AJR Am J Roentgenol. 216(6):1438-51, 2020
Yang L et al: Nasopharyngeal granulomatous mass after radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx. 43(3):330-5, 2016
Alhilali L et al: Osteoradionecrosis after radiation therapy for head and neck cancer: differentiation from recurrent disease with CT and PET/CT imaging. AJNR Am J Neuroradiol. 35(7):1405-11, 2014
Saito N et al: Posttreatment CT and MR imaging in head and neck cancer: what the radiologist needs to know. Radiographics. 32(5):1261-82; discussion 1282-4, 2012
Berg EE et al: Pathologic effects of external-beam irradiation on human vocal folds. Ann Otol Rhinol Laryngol. 120(11):748-54, 2011
Bisdas S et al: Perfusion CT in squamous cell carcinoma of the upper aerodigestive tract: long-term predictive value of baseline perfusion CT measurements. AJNR Am J Neuroradiol. 31(3):576-81, 2010
Faggioni L et al: CT perfusion of head and neck tumors: how we do it. AJR Am J Roentgenol. 194(1):62-9, 2010
Glastonbury CM et al: The postradiation neck: evaluating response to treatment and recognizing complications. AJR Am J Roentgenol. 195(2):W164-71, 2010
Yoo JS et al: Osteoradionecrosis of the hyoid bone: imaging findings. AJNR Am J Neuroradiol. 31(4):761-6, 2010
Debnam JM et al: Benign ulceration as a manifestation of soft tissue radiation necrosis: imaging findings. AJNR Am J Neuroradiol. 29(3):558-62, 2008
Abdel Razek AA et al: Role of diffusion-weighted echo-planar MR imaging in differentiation of residual or recurrent head and neck tumors and posttreatment changes. AJNR Am J Neuroradiol. 28(6):1146-52, 2007
Sanguineti G et al: Dosimetric predictors of laryngeal edema. Int J Radiat Oncol Biol Phys. 68(3):741-9, 2007
Mukherji SK et al: Imaging of the post-treatment larynx. Eur J Radiol. 44(2):108-19, 2002
Nömayr A et al: MRI appearance of radiation-induced changes of normal cervical tissues. Eur Radiol. 11(9):1807-17, 2001
Filntisis GA et al: Laryngeal radionecrosis and hyperbaric oxygen therapy: report of 18 cases and review of the literature. Ann Otol Rhinol Laryngol. 109(6):554-62, 2000
Baron-Hay S et al: Life threatening laryngeal toxicity following treatment with combined chemoradiotherapy for nasopharyngeal cancer: a case report with review of the literature. Ann Oncol. 10(9):1109-12, 1999
De Vuysere S et al: CT findings in laryngeal chondroradionecrosis. JBR-BTR. 82(1):16-8, 1999
Fitzgerald PJ et al: Delayed radionecrosis of the larynx. Am J Otolaryngol. 20(4):245-9, 1999
Hermans R et al: CT findings in chondroradionecrosis of the larynx. AJNR Am J Neuroradiol. 19(4):711-8, 1998
Schmalfuss IM et al: Arytenoid cartilage sclerosis: normal variations and clinical significance. AJNR Am J Neuroradiol. 19(4):719-22, 1998
Greven KM et al: Can positron emission tomography distinguish tumor recurrence from irradiation sequelae in patients treated for larynx cancer? Cancer J Sci Am. 3(6):353-7, 1997
Greven KM et al: Positron emission tomography of patients with head and neck carcinoma before and after high dose irradiation. Cancer. 74(4):1355-9, 1994
Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part I. Expected changes. Radiology. 193(1):141-8, 1994
Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part II. Primary site response. Radiology. 193(1):149-54, 1994
Tart RP et al: Value of laryngeal cartilage sclerosis as a predictor of outcome in patients with stage T3 glottic cancer treated with radiation therapy. Radiology. 192(2):567-70, 1994
Tartaglino LM et al: Imaging of radiation changes in the head and neck. Semin Roentgenol. 29(1):81-91, 1994
Briggs RJ et al: Laryngeal imaging by computerized tomography and magnetic resonance following radiation therapy: a need for caution. J Laryngol Otol. 107(6):565-8, 1993
Bronstein AD et al: Soft-tissue changes after head and neck radiation: CT findings. AJNR Am J Neuroradiol. 10(1):171-5, 1989
STATdx includes over 200,000 searchable images, including x-ray, CT, MR, and ultrasound images. To access all images, please log in or subscribe.