Radiation Therapy for Lung Cancer: Imaging Appearances and Pitfalls

Clin Chest Med. 2024 Jun;45(2):339-356. doi: 10.1016/j.ccm.2024.02.007. Epub 2024 Mar 27.

Abstract

Radiation therapy is part of a multimodality treatment approach to lung cancer. The radiologist must be aware of both the expected and the unexpected imaging findings of the post-radiation therapy patient, including the time course for development of post- radiation therapy pneumonitis and fibrosis. In this review, a brief discussion of radiation therapy techniques and indications is presented, followed by an image-heavy differential diagnostic approach. The review focuses on computed tomography imaging examples to help distinguish normal postradiation pneumonitis and fibrosis from alternative complications, such as infection, local recurrence, or radiation-induced malignancy.

Keywords: Cancer; Fibrosis; Imaging; Lung; Pneumonitis; Radiation; Radiology.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Humans
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / radiotherapy
  • Radiation Pneumonitis / diagnostic imaging
  • Radiation Pneumonitis / etiology
  • Tomography, X-Ray Computed*