Journal of Clinical & Experimental Radiology (JCER) is a peer reviewed Open Access journal that publishes latest advancements and innovations in the field of Clinical radiology and its impact on healthcare practices.

The Journal aims to provide a forum for widespread dispersal of research in diagnostic and therapeutic Radiology and Imaging Science covering all the research areas of Medical Imaging Studies that encompasses:

Imaging diagnosis of recurrent disease is challenging in the post-treatment neck, particularly with flap reconstruction of complex head and neck post-surgical cancer defects. These may be further complicated by post-operative radiation. Distortion of anatomy and loss of normal neck symmetry after surgical resection and from radiation fibrosis also limits clinical assessment, and despite the promise of imaging, many modalities are limited by false-positive results, particularly in the early post-surgical period. Contrast enhanced cross-sectional imaging, particularly CT, remains the mainstay for evaluating patients early in the post-treatment period and for routine surveillance and patterns of disease recurrence can be readily apparent to the experienced eye

This study is to provide a comprehensive description of the spectrum of imaging characteristics and distribution of recurrent disease in patients with cancers of the head and neck reconstructed with flaps, which may allow salvage surgery and contribute to improved survival.

Computed Tomography images and clinical data of all consecutive patients who underwent head and neck tumor resection, neck dissection and flap reconstruction over 7.5 year period were reviewed. Imaging findings were correlated with flap type, recurrence site, and time to recurrence and clinical suspicion.

Over 79% of patients in our study developed recurrent disease within the first eight months following the surgery (median 5 months). Only 17% of patients recurred more than a year after the treatment. This underscores the importance of early routine imaging of patients with flap reconstruction, and the importance of vigilance to imaging evidence of recurrence. While there are a number of recommendations for post-treatment follow-up and the site specific recommendations vary widely, study suggests that the first imaging study in patients with advanced stage cancer should be obtained at 3 months then repeated every 3 months for the first year.

The majority of patients with recurrent disease following flap reconstruction developed their recurrence within the post-operative first eight months. Recurrent tumors typically present as infiltrating, enhancing masses which may have necrotic foci, and tend to occur along the flap margin and/or suture line. Approximately 38% of recurrences were not clinically suspected. Routine 3-month baseline imaging then further 3-month interval follow-up in the first year should be considered in patients with flap reconstruction for head and neck malignancy.

A standard editorial manager system is utilized for manuscript submission, review, editorial processing and tracking which can be securely accessed by the authors, reviewers and editors for monitoring and tracking the article processing. Manuscripts can be uploaded online at  Editorial Tracking System or as an email attachment to clinradiol@scitecjournals.com