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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
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
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
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
Related Anatomy
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Related Differential Diagnoses
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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
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
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