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Assessment of Locally Recurrent Disease, Response to Chemo- and Radiotherapy, and Special Considerations

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Imaging of Primary Tumors of the Osseous Spine

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

This chapter gives a short overview of the expected imaging appearance of postoperative findings, postoperative recurrence, and potential postoperative complications that may occur after treatment of tumors of the osseous spine. Furthermore, assessment of response to chemo- and radiotherapy is discussed. Magnetic resonance imaging (MRI), including morphological sequences, dynamic contrast-enhanced imaging, and diffusion-weighted imaging, is the preferred technique to differentiate expected postoperative changes such as edema and fibrosis from local recurrence. Complementary computed tomography (CT) may add information by demonstrating osteolysis, detection of chondroid calcifications in recurrent cartilage tumors of chordoma, and calcified osteoid matrix in recurrent osteosarcoma. Positron emission tomography (PET)/CT and WBMRI have a complementary role in the posttreatment evaluation of lymphoma. PET/CT also has a role in the evaluation of posttreatment response of plasmacytoma.

Complications such as damage to neural structures, flap reconstruction failure, CSF leak with formation of pseudomeningocele, vascular injury, wound-related complications such as tissue necrosis, wound dehiscence, hematomas, seromas, infections, and development of extensive fibrosis are also best evaluated on MRI. CT is, however, the mainstay for hardware and bone graft failure.

Mimickers of poor response to chemotherapy include early granulation tissue, bone marrow changes due to chemotherapy or irradiation, radiation necrosis, and insufficiency fractures.

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Authors and Affiliations

  1. 2nd Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Chaidari, Greece

    Olympia Papakonstantinou

  2. Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK

    Snehansh Roy Chaudhary

  3. Department of Biomedical Imaging and Image-Guided Therapy, Vienna General Hospital, Medical University of Vienna, Vienna, Austria

    Smilla Pusitz

  4. Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria

    Iris-Melanie Nöebauer-Huhmann

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  1. Department of Radiology, M Kassab Orthopedic Institute, Tunis, Tunisia

    Mohamed Fethi Ladeb

  2. Department of Radiology, AZ Sint-Maarten Mechelen, Mechelen, Belgium

    Filip Vanhoenacker

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Papakonstantinou, O., Chaudhary, S.R., Pusitz, S., Nöebauer-Huhmann, IM. (2024). Assessment of Locally Recurrent Disease, Response to Chemo- and Radiotherapy, and Special Considerations. In: Ladeb, M.F., Vanhoenacker, F. (eds) Imaging of Primary Tumors of the Osseous Spine. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2024_478

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  • DOI: https://doi.org/10.1007/174_2024_478

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  • Print ISBN: 978-3-031-56885-5

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