link
Bookmarks
Head and Neck
Diagnosis
Hypopharynx, Larynx, and Cervical Trachea
Treatment-Related Lesions
Postradiation Larynx
Postradiation Larynx
Troy A. Hutchins, MD; Joshua E. Lantos, MD
To access 4,300 diagnoses written by the world's leading experts in radiology.Try it free - 15 days
0
7
2
3

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

                                        1. 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
                                        2. 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
                                        3. 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
                                        4. Yang L et al: Nasopharyngeal granulomatous mass after radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx. 43(3):330-5, 2016
                                        5. 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
                                        6. 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
                                        7. Berg EE et al: Pathologic effects of external-beam irradiation on human vocal folds. Ann Otol Rhinol Laryngol. 120(11):748-54, 2011
                                        8. 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
                                        9. Faggioni L et al: CT perfusion of head and neck tumors: how we do it. AJR Am J Roentgenol. 194(1):62-9, 2010
                                        10. Glastonbury CM et al: The postradiation neck: evaluating response to treatment and recognizing complications. AJR Am J Roentgenol. 195(2):W164-71, 2010
                                        11. Yoo JS et al: Osteoradionecrosis of the hyoid bone: imaging findings. AJNR Am J Neuroradiol. 31(4):761-6, 2010
                                        12. 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
                                        13. 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
                                        14. Sanguineti G et al: Dosimetric predictors of laryngeal edema. Int J Radiat Oncol Biol Phys. 68(3):741-9, 2007
                                        15. Mukherji SK et al: Imaging of the post-treatment larynx. Eur J Radiol. 44(2):108-19, 2002
                                        16. Nömayr A et al: MRI appearance of radiation-induced changes of normal cervical tissues. Eur Radiol. 11(9):1807-17, 2001
                                        17. 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
                                        18. 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
                                        19. De Vuysere S et al: CT findings in laryngeal chondroradionecrosis. JBR-BTR. 82(1):16-8, 1999
                                        20. Fitzgerald PJ et al: Delayed radionecrosis of the larynx. Am J Otolaryngol. 20(4):245-9, 1999
                                        21. Hermans R et al: CT findings in chondroradionecrosis of the larynx. AJNR Am J Neuroradiol. 19(4):711-8, 1998
                                        22. Schmalfuss IM et al: Arytenoid cartilage sclerosis: normal variations and clinical significance. AJNR Am J Neuroradiol. 19(4):719-22, 1998
                                        23. 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
                                        24. 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
                                        25. Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part I. Expected changes. Radiology. 193(1):141-8, 1994
                                        26. Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part II. Primary site response. Radiology. 193(1):149-54, 1994
                                        27. 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
                                        28. Tartaglino LM et al: Imaging of radiation changes in the head and neck. Semin Roentgenol. 29(1):81-91, 1994
                                        29. 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
                                        30. 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

                                                                              1. 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
                                                                              2. 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
                                                                              3. 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
                                                                              4. Yang L et al: Nasopharyngeal granulomatous mass after radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx. 43(3):330-5, 2016
                                                                              5. 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
                                                                              6. 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
                                                                              7. Berg EE et al: Pathologic effects of external-beam irradiation on human vocal folds. Ann Otol Rhinol Laryngol. 120(11):748-54, 2011
                                                                              8. 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
                                                                              9. Faggioni L et al: CT perfusion of head and neck tumors: how we do it. AJR Am J Roentgenol. 194(1):62-9, 2010
                                                                              10. Glastonbury CM et al: The postradiation neck: evaluating response to treatment and recognizing complications. AJR Am J Roentgenol. 195(2):W164-71, 2010
                                                                              11. Yoo JS et al: Osteoradionecrosis of the hyoid bone: imaging findings. AJNR Am J Neuroradiol. 31(4):761-6, 2010
                                                                              12. 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
                                                                              13. 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
                                                                              14. Sanguineti G et al: Dosimetric predictors of laryngeal edema. Int J Radiat Oncol Biol Phys. 68(3):741-9, 2007
                                                                              15. Mukherji SK et al: Imaging of the post-treatment larynx. Eur J Radiol. 44(2):108-19, 2002
                                                                              16. Nömayr A et al: MRI appearance of radiation-induced changes of normal cervical tissues. Eur Radiol. 11(9):1807-17, 2001
                                                                              17. 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
                                                                              18. 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
                                                                              19. De Vuysere S et al: CT findings in laryngeal chondroradionecrosis. JBR-BTR. 82(1):16-8, 1999
                                                                              20. Fitzgerald PJ et al: Delayed radionecrosis of the larynx. Am J Otolaryngol. 20(4):245-9, 1999
                                                                              21. Hermans R et al: CT findings in chondroradionecrosis of the larynx. AJNR Am J Neuroradiol. 19(4):711-8, 1998
                                                                              22. Schmalfuss IM et al: Arytenoid cartilage sclerosis: normal variations and clinical significance. AJNR Am J Neuroradiol. 19(4):719-22, 1998
                                                                              23. 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
                                                                              24. 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
                                                                              25. Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part I. Expected changes. Radiology. 193(1):141-8, 1994
                                                                              26. Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part II. Primary site response. Radiology. 193(1):149-54, 1994
                                                                              27. 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
                                                                              28. Tartaglino LM et al: Imaging of radiation changes in the head and neck. Semin Roentgenol. 29(1):81-91, 1994
                                                                              29. 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
                                                                              30. Bronstein AD et al: Soft-tissue changes after head and neck radiation: CT findings. AJNR Am J Neuroradiol. 10(1):171-5, 1989