Purpose
Radiation-induced lung injury (RILI) is one of the important common complications occurring during or after the thoracic radiotherapy,
and it is a major limiting factor for radiation therapy demanding increased awareness and early clinical recognition of this entity (1-3).
The acute RILI (ARILI) is defined by the US Radiation Therapy Oncology Group (RTOG) as RILI occurring within 90 days after commencement of radiotherapy(4).
Manifestations of ARILI on HRCT images are considered to be the most objective and reliable evidence for diagnosis of this entity(5-8).
However,...
Methods and Materials
1.
Study subjects
Patients with upper esophageal cancers or malignant thymomas scheduled for post-operative radiotherapy during the period June 2007 to May 2012 were screened and selected,
and then underwent HRCT and CTPI examinations for this study.
All patients received 3 dimensional conformal radiotherapy (3D-CRT).
Inclusion criteria were as follows: ①total irradiation dose 60 - 62Gy; ②radiation dose per time: 2Gy/2 days; ③course of radiotherapy approximately 8 weeks; ④ V20 ( defined as the percentage of pulmonary volume irradiated to >20 Gy,
i.e.
percentage of...
Results
1.
ARILI diagnosis overview:
According to the the RTOG criteria for ARILI diagnosis,
ARILI was observed in 18 patients out of 51 within 12 weeks after administration of radiotherapy.
Among the 18 patients with ARILI,
11 cases (11/18) occurred in the middle of the radiotherapy course (in week 4,
about 30 Gy dose),
7 cases (7/18) occurred at the end of radiotherapy course (in week 8) and one month later (in week 12).
Typical HRCT manifestations of ARILI (all in the irradiated lung area) were...
Conclusion
1.
Early detection and diagnosis of ARILI
At present comprehensive clinical diagnosis (history of radiotherapy,
signs and symptoms ,
peripheral blood test and imaging examination) and follow-up evaluation are commonly used,
where the imaging examination,
especially HRCT,
provides the most direct evidence for the diagnosis of ARILI [7,8,14].
However,
studies indicate that when positive ARILI diagnosis is made by HRCT,
the RILI in most patients has progressed into irreversible phase [15].
HRCT visualizes the general morphological changes of lesions.
However,
according to studies in brain...
References
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Pulmonary radiation injury.
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Togami T,
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Nishiyama Y,
Ohkawa M,
et al. Radiation pneumonitis in patients with lung and mediastinal tumours: a retrospective study of risk factors focused on pulmonary emphysema.
Br J Radiol 2012;85: 135-141.
Kim TH,
Cho KH,
Pyo HR,
Lee JS,
Zo JI,
et al.
Dose-volumetric parameters for predicting severe radiation pneumonitis after three-dimensional conformal radiation therapy for lung cancer.
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Cox JD,
Stetz J,
Pajak TF....
Personal Information
Xiao-yun Hu MD,
Imaging Center,
Wuxi People's Hospital,
Nanjing Medical University,
Jiangsu,
China;
[email protected]
Xiang-ming Fang MD,
Imaging Center,
Wuxi People's Hospital,
Nanjing Medical University,
Jiangsu,
China;
[email protected]
Hong-wei Chen MD,
Imaging Center,
Wuxi People's Hospital,
Nanjing Medical University,
Jiangsu,
China;
[email protected]
Chun-hong Hu MD,
ImagingCenter,
The First Affiliated Hospital of Suzhou University,
Jiangsu ,
China
[email protected]