Regional Radiation Pneumonitis After SIRT of a Subcapsular Liver Metastasis: What is the Effect of Direct Beta Irradiation?
We herein present a patient undergoing selective internal radiation therapy with an almost normal lung shunt fraction of 11.5%, developing histologically proven radiation pneumonitis. Due to a predominance of pulmonary consolidations in the right lower lung and its proximity to a large liver metastases located in the dome of the right liver lobe a Monte Carlo simulation was performed to estimate the effect of direct irradiation of the lung parenchyma. According to our calculations direct irradiation seems negligible and RP is almost exclusively due to ectopic draining of radioactive spheres.
Department of Interventional, Pediatric and Diagnostic Radiology, Inselspital, University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland, tomas.dobrocky@insel.ch.
Tomas
T
Dobrocky
Markus
M
Fuerstner
Bernd
B
Klaeser
Ruben
R
Lopez-Benitez
Yara Banz
YB
Wälti
Levent
L
Kara
D000328:Adult; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008863:Microspheres; D009010:Monte Carlo Method; D016609:Neoplasms, Second Primary / Q000532:radiotherapy*; D017564:Radiation Pneumonitis / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D019043:Vascular Neoplasms / Q000473:pathology* / Q000601:surgery; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
D015021:Yttrium Radioisotopes