الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Multimodality treatment is required for cervical cancer shows locally advanced behavior (stage III and IV) with no distant metastases. It combine surgery aiming to cure with adjuvant radiotherapy, and may be associated with chemotherapy or not.
The possible radiological features in patients treated from cervical cancers include post surgical anatomical changes, post irradiation changes, tumor recurrence and post treatment complications.
It is hard to differentiate predicted treatment-induced changes and recurrent lesions or complications because of these post-treatment changes. Therefore, it is necessary to do a baseline study assessment to be as a reference in post-treatment follow-up evaluation.
CT is an appropriate imaging tool for follow up in most patients with cervical cancer since CT is increasingly available, lower cost, provides short time of examination which consequently leads to less motion artifacts with better assessment of bones and calcifications. The examination can be easily extended for staging purposes to the whole body.
This study is aimed to highlight the role of CT imaging in differentiation between post treatment changes and recurrent cervical cancers. Our study is consisted of 27 patients including 17 males (62.9%) and 10 females (37.03%) with ages ranging from 25-66 years.
Tumors involved are with different pathological types including cancer larynx 44.4%, nasopharyngeal carcinoma 14.8%, salivary glands cancers 14.8%, cancer tongue 11.1%, cancer thyroid 7.4%, eye lid carcinoma 3.7% and mandibular alveolar process carcinoma 3.7%. As regards the treatment modalities 59.3% of the patients were operated, while 40.7% were not operated. According to chemoradiotherapy there was 7.4% of the patients received chemotherapy, 33.3% received radiotherapy, 44.4% received both while there was 14.8% did not receive radiotherapy nor chemotherapy.
In our study CT could detect recurrence in 10 patients from 10 (37.03%) and detect post treatment changes/complications in 17 from 17 (62.9%) with sensitivity 100%, specificity 100%, ppv 100%, npv 100% and accuracy 100%.
To summerize, CT can predict recurrent malignant lesions and diffrentaiate it from post treatment changes in majority of cases. Recurrence appears as heterogenous infiltrating mass with irregular boundries and heterogenous post contrast enhancement which shows progression on follow up studies while post treatment changes are stationary on follow up with homogenous enhancement and regular boundries.