CTICasesRadiation Pneumonitis
Imaging findings
CT of the chest in a patient with history of metastatic endometrial cancer shows new, focal consolidative opacities in the right upper lobe. Review of the patient's prior radiation treatment planning data demonstrates the opacity corresponds precisely to the shape and margins of the radiation field (isodose curves) used to treat subcarinal lymph node metastases, consistent with radiation pneumonitis.
Key takeaways
Radiation pneumonitis is a localized inflammatory reaction that typically occurs 1 to 6 months after completing radiation therapy. It is characterized on CT by consolidation and ground-glass opacity restricted to the radiation port, often with straight borders that do not respect anatomical boundaries. Correlating the imaging findings with the radiation plan is key to correct diagnosis.
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