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Semin Musculoskelet Radiol 2022; 26(03): 338-353
DOI: 10.1055/s-0041-1740995
Review Article

Effects of Radiation Therapy and Chemotherapy on the Musculoskeletal System

Maria Pilar Aparisi Gómez
1   Department of Radiology, Auckland City Hospital, Auckland, New Zealand
2   Department of Radiology, IMSKE, Valencia, Spain
,
Francisco Aparisi
3   Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
,
Alessio Giuseppe Morganti
4   Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
5   Department of Experimental, Diagnostic and Specialty Medicine – DIMES, Alma Mater Studiroum Bologna University, Bologna, Italy
,
Stefano Fanti
5   Department of Experimental, Diagnostic and Specialty Medicine – DIMES, Alma Mater Studiroum Bologna University, Bologna, Italy
6   Nuclear Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
,
Alberto Bazzocchi
7   Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Abstract

The effects of radiation and chemotherapy on the musculoskeletal (MSK) system are diverse, and interpretation may be challenging. The different lines of treatment have effects on diseased and normal marrow, and they may lead to complications that must be differentiated from recurrence or progression. This review analyzes the changes induced by radiotherapy and chemotherapy in the MSK system in the adult and pediatric population, and the expected associated imaging findings. Treatments are often combined, so the effects may blend. Awareness of the spectrum of changes, complications, and their imaging appearances is paramount for the correct diagnosis. The assessment of body composition during and after treatment allows potential interventions to implement long-term outcomes and personalize treatments. Imaging techniques such as computed tomography or magnetic resonance imaging provide information on body composition that can be incorporated into clinical pathways. We also address future perspectives in posttreatment assessment.

Keywords

chemotherapy - radiotherapy - bone marrow imaging - oncologic imaging - magnetic resonance imaging


Publication History

Article published online:
02 June 2022

© 2022. Thieme. All rights reserved.

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