The postradiation neck: evaluating response to treatment and recognizing complications

AJR Am J Roentgenol. 2010 Aug;195(2):W164-71. doi: 10.2214/AJR.09.4122.


Objective: We summarize the rationale for and physiology of radiation therapy for the treatment of head and neck cancer and review the imaging findings of expected changes and complications after radiation to the neck. It is important to be able to recognize these features at all stages during management of patients with squamous cell carcinoma and other head and neck malignancies and to be able to distinguish these changes from residual or recurrent disease.

Conclusion: Radiation therapy results in imaging findings of tissue edema followed by fibrosis, scarring, and atrophy. Complications from radiation therapy can occur months to years after treatment. Findings of a new mass, lymphadenopathy, or bone or cartilage destruction must be viewed as concerning for recurrent disease.

MeSH terms

  • Diagnostic Imaging / methods*
  • Head and Neck Neoplasms / complications*
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Radiation Injuries / diagnosis*
  • Radiation Injuries / etiology
  • Radiation Injuries / therapy*
  • Radiotherapy, Conformal / adverse effects*