title: Extent and computed tomography appearance of early radiation induced lung injury for non-small cell lung cancer.
abstract: The present study investigates the extent and appearance of radiologic injury in the lung after radiotherapy for non-small cell lung cancer (NSCLC) patients and correlates radiologic response with clinical and dosimetric factors.
  
  
  
  Eligible follow-up CT scans acquired up to six months after radiotherapy were evaluated for radiologic injuries in 220 NSCLC patients. Radiologic injuries were divided into three categories: (1) interstitial changes, (2) ground-glass opacity, or (3) consolidation. The relationship between the fraction of injured lung of each category and clinical or dosimetric factors was investigated.
  
  
  
  Radiological injuries of category 1-3 were found in 67%, 52%, and 51% of the patients, and the mean (and maximum) fraction of injured lung was 4.4% (85.9%), 2.4% (46.0%), and 2.1% (22.9%), respectively. Traditional lung dose metrics and time to follow-up predicted lung injury of all categories. Older age increased the risk of interstitial changes and current smoking reduced the risk of consolidation in the lung.
  
  
  
  Radiologic injuries were frequently found in follow-up CT scans after radiotherapy for NSCLC patients. The risk of a radiologic response increased with increasing time and lung dose metrics, and depended on patient age and smoking status.
authors.affiliation: Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark. Electronic address: uffe.bernchou@rsyd.dk.
authors.forename: Uffe
authors.initials: U
authors.lastname: Bernchou
authors.affiliation: Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark.
authors.forename: Rasmus Lübeck
authors.initials: RL
authors.lastname: Christiansen
authors.affiliation: Department of Radiology, Odense University Hospital, Odense, Denmark.
authors.forename: Jon Thor
authors.initials: JT
authors.lastname: Asmussen
authors.affiliation: Department of Oncology, Odense University Hospital, Odense, Denmark.
authors.forename: Tine
authors.initials: T
authors.lastname: Schytte
authors.affiliation: Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark.
authors.forename: Olfred
authors.initials: O
authors.lastname: Hansen
authors.affiliation: Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark.
authors.forename: Carsten
authors.initials: C
authors.lastname: Brink
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008168:Lung / Q000528:radiation effects; D055370:Lung Injury / Q000209:etiology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology*; D016634:Radiosurgery / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Computed tomography appearance; Lung cancer; Radiologic lung injury; Response modelling