Evolving Role of PET Imaging in Assessing Vascular and Central Nervous System Complications of Radiation Therapy in Head and Neck Cancer.

Radiation therapy for head and neck cancer is a cornerstone of treatment but can come with significant and lasting complications. Reduced vascularity and fibrosis heighten the risks of stroke, infection, and diminished quality of life. Advances in imaging technologies, such as fluorodeoxyglucose PET and sodium fluoride-PET, have emerged as critical tools for diagnosing and monitoring vascular inflammation and calcification, enabling earlier interventions and improved patient management. This review examines the pathophysiology of RT-induced damage, with a focus on vascular and connective tissue complications, and highlights the evolving role of PET imaging in early detection and management of these effects.