Marin Alisa McDonald MD, PhD, Presenter: Nothing to Disclose

Julie Bykowski MD, Abstract Co-Author: Nothing to Disclose

Understanding the expected appearance of surgical resection, reconstruction and post-radiation changes is critical for appropriate diagnosis of treatment complications and recurrence. Awareness of limitations of CT, MR and PET in the determination of recurrence.  

1. Review of NCCN guidelines for surgical and/or adjuvant treatment of head and neck squamous cell carcinoma, based on stage and adverse features on pathology. 2. Case series illustrating expected CT, MR and PET post-operative and post-radiation treatment changes and corresponding symptoms with those of proven complications or recurrence. Specific case series include: lymph node dissection changes, persistent nodes after radiation therapy (Fig 1), lymphatic recurrence myocutaneous flap reconstruction (Fig 2), flap failure, recurrence at flap margin (Fig 3) soft tissue edema (Fig 4), soft tissue infection (Fig 5), local recurrence chondronecrosis, cartilage invasion osteonecrosis, osteomyelitis, direct osseous invasion, osseous metastases delayed sarcoma after prior radiation recurrence in patients who are immunocompromised or have 2nd malignancy 3. Brief self-assessment test to consolidate the basic principles and approach for successful diagnosis of these complicated cases.  

http://abstract.rsna.org/uploads/2014/14016813/14016813_3vzg.pdf

McDonald, M, Bykowski, J, Fat, Flaps and Failures: The Complicated Evaluation for Recurrence in the Post-Treatment Neck.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016813.html