Multidetector CT evaluation of airway stents: what the radiologist should know.

Airway stents are increasingly used to treat symptomatic patients with obstructive tracheobronchial diseases who are not amenable to surgical resection or who have poor performance status, precluding them from resection. The most common conditions that are treated with tracheobronchial stents are primary lung cancer and metastatic disease. However, stents have also been used to treat patients with airway stenosis related to a variety of benign conditions, such as tracheobronchomalacia, relapsing polychondritis, postintubation tracheal stenosis, postoperative anastomotic stenosis, and granulomatous diseases. Additionally, airway stents can be used as a barrier method in the management of esophagorespiratory fistulas. Many types of stents are available from different manufacturers. Principally, they are classified as silicone; covered and uncovered metal; or hybrid, which are made of silicone and reinforced by metal rings. The advantages and disadvantages of each type of airway stent are carefully considered when choosing the most appropriate stent for each patient. Multidetector computed tomography plays an important role in determining the cause and assessing the location and extent of airway obstruction. Moreover, it is very accurate in its depiction of complications after airway stent placement.

Cardiac complications of oncologic therapy.

As survival rates continue to increase for patients with childhood and adult malignancies, imaging utilization in these patients will likely increase substantially. It is important to detect disease recurrence and to recognize the potential complications that occur after treatment with oncologic medications and therapeutic radiation. The most common cardiotoxic side effect of the anthracycline drug class is a dose-dependent decline in ejection fraction, which may result in dilated cardiomyopathy. Multiple-uptake gated acquisition (MUGA) scanning plays an important role in diagnosis of this subclinical cardiac dysfunction. Other less common cardiotoxic side effects of chemotherapeutic medications include arrhythmia, myocarditis, coronary artery disease, tamponade, pericarditis, and pericardial effusion. Radiation therapy can also lead to cardiotoxicity when the heart or pericardium is included in the radiation portal. Radiation-induced conditions include pericardial disease, coronary artery disease, valvular disease, and cardiomyopathy. Many of these side effects are asymptomatic until late in the course of the disease. With imaging, these pathologic conditions can often be diagnosed before symptom onset, which may allow early intervention. Radiologists should be familiar with the current knowledge and pathophysiology regarding cardiac complications related to chemotherapy and radiation therapy of malignant neoplasms and the appearances of treatment-related cardiotoxicity that can be found at radiography, nuclear medicine examinations, and cross-sectional imaging. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.336125005/-/DC1.