Radiation Pneumonitis - Why Are We Still Guessing?

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  • Gad, Sandra
    • School of Medicine, Department of Radiology
  • Mohansky, Michael
    • School of Medicine
  • Villalobos, Alex
    • School of Medicine, Department of Radiology
  • Du Pisanie, Lourens
    • School of Medicine, Department of Radiology
  • Kokabi, Nima
    • School of Medicine, Department of Radiology
Abstract
  • Radiation pneumonitis (RP), 1 is a type of radiation-induced lung injury that has traditionally been a clinical diagnosis based on the history of radiation exposure to the lungs, imaging findings, and the presence of classic symptoms after the exclusion of other etiologies [1,2]. RP has been recognized since the early days of X-ray utilization in the early 1900s [1,3]. RP’s clinical presentation, specifically its delayed time of onset and insidious severity, depend heavily on several patient factors that make it difficult to predict onset and to provide treatment in a timely fashion. Patients with RP generally present with dry cough several weeks post radiation-based therapy with computed tomography (CT) demonstrating bilateral symmetric ground-glass opacities and consolidations with relative peripheral/hilar sparing “bat wing appearance.” While radiation-induced lung injury as a clinical complication was initially described by radiation oncology, with the increased use of yttrium-90 (Y-90) trans-arterial radioembolization (TARE), several interventional radiology (IR) groups have reported RP post-TARE [5]. It is in this context, that the authors Gyano and Kis aim to provide a comprehensive systematic review of Y90-TARE radiation pneumonitis, including patient evaluation, dosimetry considerations, and clinical outcomes based on the limited existing data. Given RP’s relatively high risk of mortality (as high as 40% [2,6]) and increasing use of TARE by IR, it is imperative that IR physicians further understand the clinical and technical factors that can predispose patients to RP.
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  • Article
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  • In Copyright
Journal title
  • Journal of Vascular and Interventional Radiology
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  • Postprint
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  • 1051-0443
  • 1535-7732
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  • Elsevier

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