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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Chronic progressive radiation myelitis (CPRM)
- Delayed radiation myelopathy (DRM)
- Radiation necrosis (RN)
Definitions
- Damage of neural tissue in spinal cord following therapeutic radiation for intrinsic or adjacent neoplastic disease
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Carausu M et al: Radiation myelitis after pembrolizumab administration, with favorable clinical evolution and safe rechallenge: a case report and review of the literature. J Immunother Cancer. 7(1):317, 2019
- Khan M et al: Radiation-induced myelitis: initial and follow-up MRI and clinical features in patients at a single tertiary care institution during 20 years. AJNR Am J Neuroradiol. 39(8):1576-81, 2018
- Keřkovský M et al: Diffusion tensor imaging in radiation-induced myelopathy. J Neuroimaging. 25(5):836-40, 2015
- Mahta A et al: Radiation induced myelopathy in a patient with tongue cancer: a case report. Acta Oncol. 51(3):409-11, 2012
- Rogers LR: Neurologic complications of radiation. Continuum (Minneap Minn). 18(2):343-54, 2012
- Habrand JL et al: [Normal tissue tolerance to external beam radiation therapy: spinal cord.] Cancer Radiother. 14(4-5):269-76, 2010
- Uchida K et al: Neurological improvement associated with resolution of irradiation-induced myelopathy: serial magnetic resonance imaging and positron emission tomography findings. J Neuroimaging. 19(3):274-6, 2009
- Umeda M et al: [Gadolinium enhancement of the anterior portion of the lumbosacral roots in a case of post-irradiation lumbosacral radiculopathy.] Rinsho Shinkeigaku. 45(10):758-61, 2005
- Warscotte L et al: Concurrent spinal cord and vertebral bone marrow radionecrosis 8 years after therapeutic irradiation. Neuroradiology. 44(3):245-8, 2002
- Okada S et al: Pathology of radiation myelopathy. Neuropathology. 21(4):247-65, 2001
- Calabro F et al: MRI of radiation myelitis: a report of a case treated with hyperbaric oxygen. Eur Radiol. 10(7):1079-84, 2000
- Macbeth F: Radiation myelitis and thoracic radiotherapy: evidence and anecdote. Clin Oncol (R Coll Radiol). 12(5):333-4, 2000
- Maddison P et al: Clinical and MRI discordance in a case of delayed radiation myelopathy. J Neurol Neurosurg Psychiatry. 69(4):563-4, 2000
- Nieder C et al: Radiation myelopathy: new perspective on an old problem. Radiat Oncol Investig. 7(4):193-203, 1999
- Rampling R et al: Radiation myelopathy. Curr Opin Neurol. 11(6):627-32, 1998
- Alfonso ER et al: Radiation myelopathy in over-irradiated patients: MR imaging findings. Eur Radiol. 7(3):400-4, 1997
- Koehler PJ et al: Delayed radiation myelopathy: serial MR-imaging and pathology. Clin Neurol Neurosurg. 98(2):197-201, 1996
- Wong CS et al: Radiation myelopathy following single courses of radiotherapy and retreatment. Int J Radiat Oncol Biol Phys. 30(3):575-81, 1994
- Hirota S et al: Chronological observation in early radiation myelopathy of the cervical spinal cord: gadolinium-enhanced MRI findings in two cases. Radiat Med. 11(4):154-9, 1993
- Schultheiss TE et al: Invited review: permanent radiation myelopathy. Br J Radiol. 65(777):737-53, 1992
- Bloss JD et al: Radiation myelitis: a complication of concurrent cisplatin and 5-fluorouracil chemotherapy with extended field radiotherapy for carcinoma of the uterine cervix. Gynecol Oncol. 43(3):305-8, 1991
- Dische S: Accelerated treatment and radiation myelitis. Radiother Oncol. 20(1):1-2, 1991
- Jeremic B et al: Incidence of radiation myelitis of the cervical spinal cord at doses of 5500 cGy or greater. Cancer. 68(10):2138-41, 1991
- Magrini SM et al: Neurological damage in patients irradiated twice on the spinal cord: a morphologic and electrophysiological study. Radiother Oncol. 17(3):209-18, 1990
- Marcus RB Jr et al: The incidence of myelitis after irradiation of the cervical spinal cord. Int J Radiat Oncol Biol Phys. 19(1):3-8, 1990
- Dische S et al: Radiation myelitis and survival in the radiotherapy of lung cancer. Int J Radiat Oncol Biol Phys. 15(1):75-81, 1988
- Goldwein JW: Radiation myelopathy: a review. Med Pediatr Oncol. 15(2):89-95, 1987
- Hatlevoll R et al: Myelopathy following radiotherapy of bronchial carcinoma with large single fractions: a retrospective study. Int J Radiat Oncol Biol Phys. 9(1):41-4, 1983
- Fitzgerald RH Jr et al: Chronic radiation myelitis. Radiology. 144(3):609-12, 1982
- Worthington BS: Diffuse cord enlargement in radiation myelopathy. Clin Radiol. 30(1):117-9, 1979
- Godwin-Austen RB et al: Observations on radiation myelopathy. Brain. 98(4):557-68, 1975
- Burns RJ et al: Pathology of radiation myelopathy. J Neurol Neurosurg Psychiatry. 35(6):888-98, 1972
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Chronic progressive radiation myelitis (CPRM)
- Delayed radiation myelopathy (DRM)
- Radiation necrosis (RN)
Definitions
- Damage of neural tissue in spinal cord following therapeutic radiation for intrinsic or adjacent neoplastic disease
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Carausu M et al: Radiation myelitis after pembrolizumab administration, with favorable clinical evolution and safe rechallenge: a case report and review of the literature. J Immunother Cancer. 7(1):317, 2019
- Khan M et al: Radiation-induced myelitis: initial and follow-up MRI and clinical features in patients at a single tertiary care institution during 20 years. AJNR Am J Neuroradiol. 39(8):1576-81, 2018
- Keřkovský M et al: Diffusion tensor imaging in radiation-induced myelopathy. J Neuroimaging. 25(5):836-40, 2015
- Mahta A et al: Radiation induced myelopathy in a patient with tongue cancer: a case report. Acta Oncol. 51(3):409-11, 2012
- Rogers LR: Neurologic complications of radiation. Continuum (Minneap Minn). 18(2):343-54, 2012
- Habrand JL et al: [Normal tissue tolerance to external beam radiation therapy: spinal cord.] Cancer Radiother. 14(4-5):269-76, 2010
- Uchida K et al: Neurological improvement associated with resolution of irradiation-induced myelopathy: serial magnetic resonance imaging and positron emission tomography findings. J Neuroimaging. 19(3):274-6, 2009
- Umeda M et al: [Gadolinium enhancement of the anterior portion of the lumbosacral roots in a case of post-irradiation lumbosacral radiculopathy.] Rinsho Shinkeigaku. 45(10):758-61, 2005
- Warscotte L et al: Concurrent spinal cord and vertebral bone marrow radionecrosis 8 years after therapeutic irradiation. Neuroradiology. 44(3):245-8, 2002
- Okada S et al: Pathology of radiation myelopathy. Neuropathology. 21(4):247-65, 2001
- Calabro F et al: MRI of radiation myelitis: a report of a case treated with hyperbaric oxygen. Eur Radiol. 10(7):1079-84, 2000
- Macbeth F: Radiation myelitis and thoracic radiotherapy: evidence and anecdote. Clin Oncol (R Coll Radiol). 12(5):333-4, 2000
- Maddison P et al: Clinical and MRI discordance in a case of delayed radiation myelopathy. J Neurol Neurosurg Psychiatry. 69(4):563-4, 2000
- Nieder C et al: Radiation myelopathy: new perspective on an old problem. Radiat Oncol Investig. 7(4):193-203, 1999
- Rampling R et al: Radiation myelopathy. Curr Opin Neurol. 11(6):627-32, 1998
- Alfonso ER et al: Radiation myelopathy in over-irradiated patients: MR imaging findings. Eur Radiol. 7(3):400-4, 1997
- Koehler PJ et al: Delayed radiation myelopathy: serial MR-imaging and pathology. Clin Neurol Neurosurg. 98(2):197-201, 1996
- Wong CS et al: Radiation myelopathy following single courses of radiotherapy and retreatment. Int J Radiat Oncol Biol Phys. 30(3):575-81, 1994
- Hirota S et al: Chronological observation in early radiation myelopathy of the cervical spinal cord: gadolinium-enhanced MRI findings in two cases. Radiat Med. 11(4):154-9, 1993
- Schultheiss TE et al: Invited review: permanent radiation myelopathy. Br J Radiol. 65(777):737-53, 1992
- Bloss JD et al: Radiation myelitis: a complication of concurrent cisplatin and 5-fluorouracil chemotherapy with extended field radiotherapy for carcinoma of the uterine cervix. Gynecol Oncol. 43(3):305-8, 1991
- Dische S: Accelerated treatment and radiation myelitis. Radiother Oncol. 20(1):1-2, 1991
- Jeremic B et al: Incidence of radiation myelitis of the cervical spinal cord at doses of 5500 cGy or greater. Cancer. 68(10):2138-41, 1991
- Magrini SM et al: Neurological damage in patients irradiated twice on the spinal cord: a morphologic and electrophysiological study. Radiother Oncol. 17(3):209-18, 1990
- Marcus RB Jr et al: The incidence of myelitis after irradiation of the cervical spinal cord. Int J Radiat Oncol Biol Phys. 19(1):3-8, 1990
- Dische S et al: Radiation myelitis and survival in the radiotherapy of lung cancer. Int J Radiat Oncol Biol Phys. 15(1):75-81, 1988
- Goldwein JW: Radiation myelopathy: a review. Med Pediatr Oncol. 15(2):89-95, 1987
- Hatlevoll R et al: Myelopathy following radiotherapy of bronchial carcinoma with large single fractions: a retrospective study. Int J Radiat Oncol Biol Phys. 9(1):41-4, 1983
- Fitzgerald RH Jr et al: Chronic radiation myelitis. Radiology. 144(3):609-12, 1982
- Worthington BS: Diffuse cord enlargement in radiation myelopathy. Clin Radiol. 30(1):117-9, 1979
- Godwin-Austen RB et al: Observations on radiation myelopathy. Brain. 98(4):557-68, 1975
- Burns RJ et al: Pathology of radiation myelopathy. J Neurol Neurosurg Psychiatry. 35(6):888-98, 1972
