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

Chemotherapy-induced peripheral neuropathy (CIPN) is the primary dose-limiting toxicity in albumin-bound paclitaxel chemotherapy regimens. Current assessment methods based on clinical scales are limited by strong subjectivity and insufficient sensitivity, while most emerging technologies remain in the preclinical stage. Therefore, the development of objective and non-invasive imaging biomarkers is urgently needed. This review focuses on the transformative role of non-invasive imaging techniques in addressing unmet clinical needs such as the accurate imaging assessment of CIPN, and systematically analyzes the complementary value of musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI) in evaluating nervous system damage induced by albumin-bound paclitaxel-related CIPN. For key peripheral nerves including the radial nerve, ulnar nerve, median nerve, and common peroneal nerve, MSUS can visualize morphological abnormalities and hemodynamic changes in real time through high-frequency probes, enabling rapid, radiation-free anatomical assessment, and serial monitoring. MRI can detect early neurostructural damage, nerve edema, and abnormal nerve fascicle signals, while also evaluating soft-tissue lesions in the nerve trajectory area. Future research should conduct systematic validation of standardized imaging data to clarify the clinical value of these techniques as predictive biomarkers for risk stratification of CIPN. This article aims to construct a novel clinical diagnostic approach for CIPN, provide a more precise and efficient diagnostic pathway for patients with peripheral neuropathy symptoms, further support the timely formulation and implementation of targeted clinical treatment plans, and ultimately contribute to improving patient prognosis.