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The engagement of CAR T cells with CD19 on the surface of neoplastic B cells causes a systemic cytokine release, which can compromise the blood\u2010brain barrier and cause an immune effector cell\u2010associated neurotoxicity syndrome (ICANS). In a small proportion of ICANS patients who demonstrate neuroimaging abnormalities, certain distinct patterns have been recognized, including signal changes in the thalami, external capsule, and brainstem, the subcortical and\/or periventricular white matter, the splenium of the corpus callosum, and the cerebellum. On careful review of the underlying pathophysiology of ICANS, we noticed that these changes closely mirror the underlying blood\u2010brain barrier disruption and neuroinflammatory and excitotoxic effects of the offending cytokines released during ICANS. Furthermore, other uncommon complications of CD19 CAR T\u2010cell therapy such as posterior reversible encephalopathy syndrome, ocular complications, and opportunistic fungal infections can be catastrophic if not diagnosed in a timely manner, with neuroimaging playing a significant role in management. In this narrative review, we will summarize the current literature on the spectrum of neuroimaging findings in ICANS, list appropriate differential diagnoses, and explore the imaging features of other uncommon central nervous system complications of CD19 CAR T\u2010cell therapy using illustrative cases from two tertiary care institutions.<\/jats:p>","DOI":"10.1111\/jon.13138","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T15:51:52Z","timestamp":1686930712000},"page":"703-715","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Neuroimaging of complications arising after CD19 chimeric antigen receptor T\u2010cell therapy: A review"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5552-6163","authenticated-orcid":false,"given":"Soniya N.","family":"Pinto","sequence":"first","affiliation":[{"name":"Department of Diagnostic Imaging St. Jude 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