title: Rib fracture after stereotactic radiotherapy on follow-up thin-section computed tomography in 177 primary lung cancer patients.
abstract: BACKGROUND
  Chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer has recently been reported. However, its detailed imaging findings are not clarified. So this study aimed to fully characterize the findings on computed tomography (CT), appearance time and frequency of chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer
  
  
  METHODS
  A total of 177 patients who had undergone SRT were prospectively evaluated for periodical follow-up thin-section CT with special attention to chest wall injury. The time at which CT findings of chest wall injury appeared was assessed. Related clinical symptoms were also evaluated.
  
  
  RESULTS
  Rib fracture was identified on follow-up CT in 41 patients (23.2%). Rib fractures appeared at a mean of 21.2 months after the completion of SRT (range, 4-58 months). Chest wall edema, thinning of the cortex and osteosclerosis were findings frequently associated with, and tending to precede rib fractures. No patients with rib fracture showed tumors > 16 mm from the adjacent chest wall. Chest wall pain was seen in 18 of 177 patients (10.2%), of whom 14 patients developed rib fracture. No patients complained of Grade 3 or more symptoms.
  
  
  CONCLUSIONS
  Rib fracture is frequently seen after SRT for lung cancer on CT, and is often associated with chest wall edema, thinning of the cortex and osteosclerosis. However, related chest wall pain is less frequent and is generally mild if present.
authors: Department of Radiology, University of Yamanashi, Chuo City, Japan. nambu-a@gray.plala.or.jp
authors: Atsushi
authors: A
authors: Nambu
authors: Hiroshi
authors: H
authors: Onishi
authors: Shinichi
authors: S
authors: Aoki
authors: Tsuyota
authors: T
authors: Koshiishi
authors: Kengo
authors: K
authors: Kuriyama
authors: Takafumi
authors: T
authors: Komiyama
authors: Kan
authors: K
authors: Marino
authors: Masayuki
authors: M
authors: Araya
authors: Ryo
authors: R
authors: Saito
authors: Lichto
authors: L
authors: Tominaga
authors: Yoshiyasu
authors: Y
authors: Maehata
authors: Eiichi
authors: E
authors: Sawada
authors: Tsutomu
authors: T
authors: Araki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010026:Osteosclerosis / Q000209:etiology / Q000473:pathology; D011832:Radiation Injuries; D016634:Radiosurgery / Q000379:methods*; D012253:Rib Fractures; D035441:Thoracic Wall / Q000528:radiation effects; D014057:Tomography, X-Ray Computed / Q000379:methods*