Researchers have investigated whether US might be useful as a supplemental test to evaluate malignant involvement or radiation-induced plexopathy of the brachial plexus [50,83]. Kultur et al [81] in a prospective analysis of 23 patients receiving radiation therapy for breast cancer found statistically significant differences between the ipsilateral and contralateral brachial plexus on shear wave elastography; however, this technique is not routinely used outside of research settings. Variant 6: Lumbosacral plexopathy, known malignancy or post-treatment syndrome. Initial imaging. This variant encompasses lumbosacral plexopathy occurring in the setting of a known malignancy or a post- treatment syndrome occurring months to years after radiation treatment for a regional malignancy. Plexopathy In addition, patients can develop lumbosacral plexopathy in the months to years after radiation treatment for regional malignancy, which could be due to recurrent tumor or postradiation injury. Imaging can be helpful in differentiating radiation plexopathy from recurrent malignancy [20], for which management differs significantly. CT Myelography Lumbar Spine There is no relevant literature to support the use of CT myelography for evaluation of lumbosacral plexopathy in the setting of known malignancy or post-treatment syndrome. CT myelography provides high-resolution imaging of the thecal sac capable of detecting thecal sac compression or intradural masses; however, it does not directly visualize the postganglionic lumbosacral plexus. CT Lumbar Spine There is no relevant literature regarding the use of CT lumbar spine in the evaluation of lumbosacral plexopathy in the setting of known malignancy or post-treatment syndrome. CT lumbar spine cannot visualize the preganglionic nerve roots and does not fully evaluate the postganglionic lumbosacral plexus because of its narrow field of view and limited soft-tissue contrast resolution relative to MRI.
Plexopathy. Researchers have investigated whether US might be useful as a supplemental test to evaluate malignant involvement or radiation-induced plexopathy of the brachial plexus [50,83]. Kultur et al [81] in a prospective analysis of 23 patients receiving radiation therapy for breast cancer found statistically significant differences between the ipsilateral and contralateral brachial plexus on shear wave elastography; however, this technique is not routinely used outside of research settings. Variant 6: Lumbosacral plexopathy, known malignancy or post-treatment syndrome. Initial imaging. This variant encompasses lumbosacral plexopathy occurring in the setting of a known malignancy or a post- treatment syndrome occurring months to years after radiation treatment for a regional malignancy. Plexopathy In addition, patients can develop lumbosacral plexopathy in the months to years after radiation treatment for regional malignancy, which could be due to recurrent tumor or postradiation injury. Imaging can be helpful in differentiating radiation plexopathy from recurrent malignancy [20], for which management differs significantly. CT Myelography Lumbar Spine There is no relevant literature to support the use of CT myelography for evaluation of lumbosacral plexopathy in the setting of known malignancy or post-treatment syndrome. CT myelography provides high-resolution imaging of the thecal sac capable of detecting thecal sac compression or intradural masses; however, it does not directly visualize the postganglionic lumbosacral plexus. CT Lumbar Spine There is no relevant literature regarding the use of CT lumbar spine in the evaluation of lumbosacral plexopathy in the setting of known malignancy or post-treatment syndrome. CT lumbar spine cannot visualize the preganglionic nerve roots and does not fully evaluate the postganglionic lumbosacral plexus because of its narrow field of view and limited soft-tissue contrast resolution relative to MRI.