CTICasesRadiation Fibrosis Post-I-131 Therapy
Imaging findings
Serial radiographs and CTs show multiple lung nodules from metastatic tall-cell papillary thyroid cancer. Following I-131 therapy, the nodules shrink and scar, causing progressive central retraction of the lung tissue, decreased AP chest diameter, and severe peripheral compensatory emphysema.
Key takeaways
Radioiodine (I-131) therapy for thyroid metastases can cause microscopic radiation pneumonitis and subsequent disseminated fibrosis. This results in central scarring/retraction and peripheral emphysematous changes (rarefaction).
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