Effects of Radiation Therapy on Abdomen and Pelvis Imaging

A review of treatment methods and radiobiology concepts that underlie radiation-related changes seen in specific tissues at imaging.

Course ID: Q00372 Category:
Modalities: , , ,


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.75
Procedures: 1.75
Abdomen and Pelvis: 1.75

Magnetic Resonance Imaging: 1.75
Procedures: 1.75
Body: 1.75

Nuclear Medicine Technology: 1.25
Procedures: 1.25
Endocrine and Oncology Procedures: 1.25

Registered Radiologist Assistant: 3.25
Procedures: 3.25
Abdominal Section: 3.25

Sonography: 1.75
Procedures: 1.75
Abdomen: 1.50
Gynecology: 0.25

Radiation Therapy: 3.50
Safety: 0.25
Radiation Protection, Equipment Operation, and Quality Assurance: 0.25
Procedures: 3.25
Treatments: 3.25


  1. Introduction
  2. Radiation Biology: A Refresher
  3. External Radiation Delivery Techniques
    1. Traditional External-Beam Radiation Therapy
    2. Conformal Radiation Therapy
      1. Intensity-modulated Radiation Therapy
      2. Stereotactic Body Radiation Therapy
    3. Proton Beam Therapy
  4. Internal Radiation Delivery Techniques
    1. Brachytherapy
    2. Radioembolization
  5. Posttherapeutic Imaging Findings
    1. Liver
      1. Findings after External-Beam Radiation Therapy
      2. Findings after Radioembolization
    2. Spleen
    3. Pancreas
    4. Bowel
    5. Kidneys and Ureters
    6. Bladder
    7. Female Pelvic Organs
    8. Male Pelvic Organs
    9. Blood Vessels
    10. Bones and Marrow
    11. Secondary Malignancies
  6. Conclusion


Upon completion of this course, students will:

  1. differentiate the various radiation delivery techniques
  2. define innocent bystander tissue
  3. know the primary reason for cell death
  4. understand the rationale for fractionating the dose
  5. differentiate between conditional and inherent radiation sensitivity
  6. define cellular sensitivity
  7. know the most common acute effect in epithelial tissue
  8. know the effect of radiation on stromal parts of organs
  9. know which was the first cancer to be treated with radiation after 1895
  10. understand the rationale for using frontal and lateral radiographs for treatment planning
  11. define the date of progress
  12. understand dynamic moving leaves for collimation
  13. understand the significance of “beams eye view” for sparing of normal tissue
  14. know the relationship between radiosensitivity and cellular regeneration
  15. be familiar with IMRT
  16. describe how IMRT is modeled
  17. differentiate the high and low dose region in relation to IMRT
  18. understand the differences between SBRT and IMRT
  19. understand the objectives of fractionation in radiation therapy
  20. describe the physical properties of a proton beam when traversing tissues
  21. know the major advantages of proton beam therapy
  22. describe the methods for delivering radiation in brachytherapy
  23. state the radionuclide used for prostate cancer brachytherapy
  24. state the method of brachytherapy for gynecologic cancer
  25. know the type of hepatic malignancies treated by radioembolization
  26. understand the radioactive source used for radioembolization
  27. know the factors that affect the likelihood of recurrence of disease after radiation
  28. be familiar with the radiation dose ranges at which imaging changes occur
  29. describe the histologic changes in the liver after radiation therapy starts
  30. recognize the radiation changes in liver parenchyma as seen on CT images
  31. recognize that using SBRT or IMRT will change the shape of the treated zone
  32. understand the timeline in which veno-occlusive disease manifests
  33. recognize how regeneration of the liver manifests
  34. recognize the tumor changes after radioembolization
  35. state the dose at which the spleen exhibits damage
  36. know the relationship between cell turnover and radiosensitivity in the small bowel
  37. recognize the chronic effects of radiation exposure in the small bowel
  38. understand the difficulty differentiating between similar radiation effects and surgical effects
  39. recognize imaging changes due to partial exposure of the kidney to radiation for treatment of adjacent structures
  40. recognize the acute effects of radiation on the bladder
  41. know the terminology associated with ovarian preservation
  42. recognize the chronic effects of radiation in the larger blood vessels
  43. state the one tissue where radiation-induced effects are unique
  44. know which type of radiation-induced tumor is aggressive
  45. understand the basis of radiosensitivity and the resulting effects of radiation-induced injury