title: Post-Radiation Therapy Imaging Appearances in Cervical Carcinoma.
abstract: Locally advanced and node-positive cervical cancers are usually treated with external beam radiation therapy and intracavitary brachytherapy with concomitant chemotherapy. In patients with locally advanced cervical cancer, imaging plays a vital role in pretreatment planning, assessment of primary tumor response to treatment, follow-up, and evaluation of treatment-related complications. Radiation therapy planning is crucial to successful local and regional control of disease. Patient selection criteria for radiation therapy with concomitant chemotherapy are described, as is assessment of treatment response of the primary cervical tumor at magnetic resonance (MR) imaging. Image interpretation can be challenging because of radiation therapy-related changes in the pelvic organs. Expected changes in the bladder, bowel, and bone marrow after radiation therapy are described, and multimodality imaging findings at computed tomography, MR imaging, and fluorine 18 fluorodeoxyglucose positron emission tomography are illustrated. Complications after radiation therapy have declined over recent years because of targeted radiation therapy. These complications can be divided into acute and chronic effects, where acute toxic effects occur within weeks of treatment. Chronic complications include cervical stenosis, small bowel stricture, fistula formation, and insufficiency fractures. Imaging is an essential tool in the care of patients with cervical cancer treated with chemotherapy and radiation therapy. The reporting radiologist should be familiar with the expected imaging appearances of the pelvic organs after radiation therapy, as well as potential complications, to avoid pitfalls in image interpretation.
authors: From the Departments of Radiology (I.P., V.S., T.D.B., N.S., A.G.R., N.B.) and Oncology (W.H.E.P.), St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed St, London W2 1NY, England.
authors: Ioanna
authors: I
authors: Papadopoulou
authors: From the Departments of Radiology (I.P., V.S., T.D.B., N.S., A.G.R., N.B.) and Oncology (W.H.E.P.), St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed St, London W2 1NY, England.
authors: Victoria
authors: V
authors: Stewart
authors: From the Departments of Radiology (I.P., V.S., T.D.B., N.S., A.G.R., N.B.) and Oncology (W.H.E.P.), St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed St, London W2 1NY, England.
authors: Tara D
authors: TD
authors: Barwick
authors: From the Departments of Radiology (I.P., V.S., T.D.B., N.S., A.G.R., N.B.) and Oncology (W.H.E.P.), St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed St, London W2 1NY, England.
authors: Won-Ho Edward
authors: WH
authors: Park
authors: From the Departments of Radiology (I.P., V.S., T.D.B., N.S., A.G.R., N.B.) and Oncology (W.H.E.P.), St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed St, London W2 1NY, England.
authors: Neil
authors: N
authors: Soneji
authors: From the Departments of Radiology (I.P., V.S., T.D.B., N.S., A.G.R., N.B.) and Oncology (W.H.E.P.), St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed St, London W2 1NY, England.
authors: Andrea G
authors: AG
authors: Rockall
authors: From the Departments of Radiology (I.P., V.S., T.D.B., N.S., A.G.R., N.B.) and Oncology (W.H.E.P.), St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed St, London W2 1NY, England.
authors: Nishat
authors: N
authors: Bharwani
mesh_terms: D000359:Aftercare; D001918:Brachytherapy / Q000009:adverse effects; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging / Q000528:radiation effects; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009381:Neoplasms, Radiation-Induced / Q000000981:diagnostic imaging / Q000209:etiology; D010053:Ovary / Q000000981:diagnostic imaging / Q000528:radiation effects; D063868:Patient Outcome Assessment; D010384:Pelvic Bones / Q000000981:diagnostic imaging; D000072078:Positron Emission Tomography Computed Tomography; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000209:etiology; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000528:radiation effects; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D014599:Uterus / Q000000981:diagnostic imaging / Q000528:radiation effects