Radiation-induced bone injury on ¹⁸F-FDG PET/CT imaging: a case report and literature review

Radiation-induced bone injury is a delayed complication caused by long-term radiotherapy, with its incidence related to the duration and dose of radiotherapy. This disease can lead to insufficiency fracture, posing a particularly significant risk to populations susceptible to osteoporosis, such as postmenopausal women. Therefore, early detection and diagnosis of radiation-induced bone injury hold significant clinical importance. As a whole-body imaging modality, ¹⁸F-fluorodeoxyglucose PET/CT has been rarely reported in the literature related to radiation-induced bone injury. Clinicians should take care to differentiate the imaging manifestations of radiation-induced bone injury from the bone metastatic lesions of malignant tumors when applying this technique for the diagnosis of radiation-induced bone injury. The authors report a case of radiation-induced bone injury caused by radiotherapy following radical resection of vulvar cancer, and conduct a detailed discussion on the etiology, pathogenesis, clinical symptoms, diagnostic key points and preventive methods of radiation-induced bone injury in combination with relevant literature, aiming to enhance clinicians' understanding of this disease.