Radiotherapy Induced Changes in Spine and Spinal Contents

  • Joana Ramalho
  • Mauricio Castillo
Part of the Medical Radiology book series (MEDRAD)


Radiotherapy is a well-established therapeutic modality in oncology that results in survival benefits in several different cancer types, including breast, prostate, rectum, brain, lung, and head and neck cancers. It is generally used to control or eliminate malignant cells as a definitive treatment or a part of adjuvant therapy and to prevent tumor recurrence after surgery. It may also be used as palliative treatment for local disease control or symptomatic pain relief.

Side effects from radiation are usually limited to the area confined to the treatment field, and most of them are predictable and expected. The main effects on the bone include bone marrow fatty conversion, disruption of normal growth and bone maturation, scoliosis, osteonecrosis, insufficiency fractures, and secondary neoplasm formation. To evaluate radiation-induced effects on the bone marrow, it is essential to understand the normal composition and distribution of bone marrow and the normal age-related pattern of bone marrow maturation. Magnetic resonance imaging (MRI) is the only imaging technique that allows direct visualization of bone marrow with high spatial resolution.

In this chapter, the bone marrow composition and distribution will be covered, routine MRI sequences for bone marrow evaluation will be explained, and the radiation-induced changes and radiation-induced complications will be discussed.


Normal Bone Marrow Magnetic Resonance Imaging Appearance Fatty Marrow Yellow Marrow Sacral Insufficiency Fracture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  1. 1.Division of NeuroradiologyUniversity of North CarolinaChapel HillUSA

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