title: Imaging after radiation therapy of thoracic tumors.
abstract: Radiation-induced lung disease (RILD) is frequent after therapeutic irradiation of thoracic malignancies. Many technique-, treatment-, tumor- and patient-related factors influence the degree of injury sustained by the lung after irradiation. Based on the time interval after the completion of the treatment RILD presents as early and late features characterized by inflammatory and fibrotic changes, respectively. They are usually confined to the radiation port. Though the typical pattern of RILD is easily recognized after conventional two-dimensional radiation therapy (RT), RILD may present with atypical patterns after more recent types of three- or four-dimensional RT treatment. Three atypical patterns are reported: the modified conventional, the mass-like and the scar-like patterns. Knowledge of the various features and patterns of RILD is important for correct diagnosis and appropriate treatment. RILD should be differentiated from recurrent tumoral disease, infection and radiation-induced tumors. Due to RILD, the follow-up after RT may be difficult as response evaluation criteria in solid tumours (RECIST) criteria may be unreliable to assess tumor control particularly after stereotactic ablation RT (SABR). Long-term follow-up should be based on clinical examination and morphological and/or functional investigations including CT, PET-CT, pulmonary functional tests, MRI and PET-MRI.
authors: Service de radiologie, secteur cardiothoracique, cliniques universitaires St-Luc, université catholique de Louvain, avenue Hippocrate 10, 1200 Bruxelles, Belgium. Electronic address: Benoit.ghaye@uclouvain.be.
authors: B
authors: B
authors: Ghaye
authors: Service de radiothérapie, oncologique, CHU UCL Namur, site clinique et maternité Sainte-Elisabeth, 5000 Namur, Belgium.
authors: M
authors: M
authors: Wanet
authors: Service de radiologie, hôpital Ambroise-Paré, 92100 Boulogne-Billancourt, France.
authors: M
authors: M
authors: El Hajjam
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000528:radiation effects*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D009381:Neoplasms, Radiation-Induced / Q000000981:diagnostic imaging; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D011832:Radiation Injuries / Q000000981:diagnostic imaging*; D017564:Radiation Pneumonitis / Q000000981:diagnostic imaging*; D011878:Radiotherapy / Q000379:methods
keywords: Chest; Complication; Radiation therapy; Recurrence; Tumor