title: Role of (18)F-FDG PET-CT in Monitoring the Cyclophosphamide Induced Pulmonary Toxicity in Patients with Breast Cancer - 2 Case Reports.
abstract: Drug induced pulmonary toxicity is not uncommon with the use of various chemotherapeutic agents. Cyclophosphamide is a widely used chemotherapeutic drug in the treatment of breast cancer. Although rare, lung toxicity has been reported with cyclophosphamide use. Detection of bleomycin induced pulmonary toxicity and pattern of (18)F-fluorodeoxyglucose ((18)F-FDG) uptake in lungs on fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) has been elicited in literature in relation to lymphoma. However, limited data is available regarding the role of (18)F-FDG PET-CT in monitoring drug induced pulmonary toxicity in breast cancer. We here present two cases of cyclophosphamide induced drug toxicity. Interim (18)F-FDG PET-CT demonstrated diffusely increased tracer uptake in bilateral lung fields in both these patients. Subsequently there was resolution of lung uptake on (18)F-FDG PET-CT scan post completion of chemotherapy. These patients did not develop significant respiratory symptoms during chemotherapy treatment and in follow up.
authors.affiliation: Department of Nuclear Medicine, A.I.I.M.S, New Delhi, India.
authors.forename: Sameer Kamalakar
authors.initials: SK
authors.lastname: Taywade
authors.affiliation: Department of Nuclear Medicine, A.I.I.M.S, New Delhi, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Medical Oncology, A.I.I.M.S, New Delhi, India.
authors.forename: Sainath
authors.initials: S
authors.lastname: Bhethanabhotla
authors.affiliation: Department of Nuclear Medicine, A.I.I.M.S, New Delhi, India.
authors.forename: Chandrasekhar
authors.initials: C
authors.lastname: Bal
keywords: 18F-FDG PETCT; Carcinoma breast; Cyclophosphamide; Drug induced; Pulmonary toxicity