The purpose of this study will be to present imaging from our institution as case-based examples of radiation-induced mucositis, which can occur after radiotherapy for head and neck cancer patients, on CT and MRI images. We will access charts between November 1, 2009 and November 1, 2019.

Inclusion criteria: patients who have a CT or MRI of the head and neck at UF Health Jacksonville with clinically and imaging confirmed radiation-induced mucositis between November 1, 2009 and November 1, 2019 Exclusion criteria: patients who do not have a CT or MRI of the head and neck at UF Health Jacksonville with clinically and imaging confirmed radiation-induced mucositis between November 1, 2009 and November 1, 2019 Obtain records: We plan to query records of radiation-induced mucositis between November 1, 2009 to November 1, 2019 via MPower, EPIC, and the UF Proton Center database. MPower is a software database offered by UF Health Jacksonville of radiology studies and reports. The images are acquired from VISAGE/PACS. We will use EPIC to acquire laryngoscopic images and laryngoscopic reports that show radiation-induced mucositis. The UF Proton Center is a clinical database that houses an additional radiology and layngoscopic database for radiation oncology patients. Like MPower, it has querying capabilities. Access to the UF Proton Center database will allow us to also obtain laryngoscopic images and laryngoscopic reports from the patient’s chart in the UF Proton Center that correlate with the patient’s CT or MRI of the head and neck. Data coding and analysis: We will select cases and/or images that show radiation-induced mucositis on CT and MRI. Before exporting, we will remove the personal health information on the radiology images in VISAGE/PACS, which can export images without dates or identifiers, and we will label the image based on the imaging finding we will discuss. We will use the MRN so that we can confirm the patient's diagnosis and radiotherapy course in the medical record. When that is confirmed, we will then select one case from CT or MRI of the head and neck to illustrate radiation mucositis and its complications, which include: infection, ulceration, necrosis, fistula formation, and secondary neoplasm. For the laryngoscopic images, we can save the image without potential identifiers by screen-capturing the relevant images without any de-identified information that could be superimposed on the laryngoscopic image from either EPIC or the UF Proton Center database. We will label that screenshot image by its imaging findings. We will reference the laryngoscopic report to confirm the diagnosis made during laryngoscopy.