Musculoskeletal Ultrasound and MRI in the Evaluation of Chemotherapy-Induced Peripheral Neuropathy: A Review

30 January 2026 : Review article

Yuxia Zuo^{BCE 1}, Xingchao Xu^{BC 2}, Cai Wu^{E 2}, Xue Cui^{CE 2}, Xiangqi Li^{A 2*}

DOI: 10.12659/MSM.951283

Med Sci Monit 2026; 32:e951283

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Introduction Pathogenesis of Chemotherapy-Induced Neuropathy MSUS Technical Principles and Equipment Selection Characteristic MSUS Manifestations of CIPN Quantitative Assessment Parameters of MSUS Advantages and Limitations of MSUS Core Technical Principles of MRI (DTI/DKI) The Correlation Between MRI Features, CIPN Pathology, and Clinical Scales Quantitative Assessment Parameters of MRI Limitations and Reproducibility Challenges of MRI Standardized Protocol for Peripheral Nervous System Examination Future Directions Conclusions References

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Table 2 Normal ultrasonographic features of four peripheral nerves in chemotherapy-induced peripheral neuropathy (CIPN) assessment.

Nerve type	Anatomical location features	Transverse section morphology/structure	Key quantitative indicators
Radial nerve	Long course in the upper arm and forearm; most superficial near the lateral epicondyle of the humerus, adjacent to the bone surface	Round or oval shape with clear boundaries, showing a characteristic “honeycomb-like” structure (hypoechoic nerve fascicles interspersed among hyperechoic epineurium)	Diameter: 1.0–2.0 mm (with normal anatomical variations)
Ulnar nerve	Located in the ulnar groove	Flattened oval shape, showing a “honeycomb-like” structure (hypoechoic nerve fascicles enclosed by hyperechoic epineurium with clear boundaries)	Cross-sectional Area (CSA): consistently <8 mm
Median nerve	Within the carpal tunnel	Oval shape with clear boundaries of nerve fascicles, showing an alternating pattern of hypoechoic and hyperechoic signals	Cross-sectional Area (CSA): consistently <10 mm
Common peroneal nerve	Around the fibular head	Flattened cord-like shape with intact nerve fascicle structure and continuous epineurium	Diameter: <3 mm
CIPN – chemotherapy-induced peripheral neuropathy; CSA – cross-sectional area.

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