Expecting the unexpected: diagnostic imaging of side effects due to cancer treatment in children

Pediatric oncological treatments significantly improved in the last decades with a significant positive impact on survival rates. Despite these achievements, cancer therapy is affected by side effects which may represent a diagnostic challenge and influence the overall management of children with tumors. Diagnostic imaging plays a crucial role in diagnosing adverse events, distinguishing them also from potential mimickers like infections or recurrences. Radiologists and nuclear medicine physicians are expected to have a deep knowledge of the common therapeutic schemes, their potential side effects, and features at imaging. Therefore, the aim of this review is to provide a comprehensive overview of the role of imaging, including hybrid techniques, in correctly identifying and characterizing the side effects of cancer treatment in children, including a brief overview of the main therapeutic options in pediatric oncology.