Abstract
BackgroundRadiotherapy to the head and neck regions can result in serious consequences to the temporomandibular joint (TMJ) and chewing muscles. Magnetic resonance imaging (MRI) demonstrates soft-tissue alterations after radiotherapy, such as morphology and signal intensity.ObjectiveThe purpose of this review is to critically and systematically analyse the available evidence regarding the masticatory muscles alterations, as demonstrated on MRI, after radiotherapy for head and neck cancer.Data sourcesElectronic search of MEDLINE, EMBASE, EBM reviews and Scopus.Inclusion criteriaReports of any study design investigating radiation-induced changes in masticatory muscles after radiotherapy in patients with head and neck cancer were included.Results and synthesis methodsAn electronic database search resulted in 162 papers. Sixteen papers were initially selected as potentially relevant studies; however, only four papers satisfied all inclusion criteria. The included papers focused on the MRI appearance of masticatory muscles following radiotherapy protocol. Two papers reported outcome based on retrospective clinical and imaging records, whereas the remaining two papers were case reports. Irradiated muscles frequently show diffuse increase in T2 signal and post-gadolinium enhancement post-irradiation. Also, muscle size changes were reported based on subjective comparison with the contralateral side. The quality of all included papers was considered poor with high risk of bias.ConclusionThere is no evidence that MRI interpretations indicate specific radiation-induced changes in masticatory muscles. There is a clear need for a cohort study comparing patients with pre- and post-radiotherapy MRI.
Highlights
Radiotherapy to the head and neck regions can result in serious consequences to the temporomandibular joint (TMJ) and surrounding muscular structures
The included papers focused on the Magnetic resonance imaging (MRI) appearance of masticatory muscles following radiotherapy protocol
Keywords used in the search were Magnetic resonance imaging, imaging, MRI, MR, enhancement, signal alternations, masticatory muscles, neoplasms, cancer, carcinoma, head and neck, oral cavity, oropharynx, nasopharynx, radiotherapy, radiation therapy, intensity modulated radiotherapy, and medical radiation
Summary
Radiotherapy to the head and neck regions can result in serious consequences to the temporomandibular joint (TMJ) and surrounding muscular structures. Radiation-induced masticatory muscle fibrosis, inflammation and atrophy reduce jaw mobility and induce trismus [3]. The severity of these effects can be related to the radiation dose received and the amount of tissues. Magnetic resonance imaging (MRI) demonstrates soft tissue alterations after radiotherapy, such as changes in muscle morphology and signal intensity [6,7,8,9]. Radiotherapy to the head and neck regions can result in serious consequences to the temporomandibular joint (TMJ) and chewing muscles. Magnetic resonance imaging (MRI) demonstrates soft-tissue alterations after radiotherapy, such as morphology and signal intensity
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