CT findings of acute radiation-induced pneumonitis in breast cancer

Abstract

Objectives: To evaluate the CT findings of acute radiation pneumonitis (RP) in breast cancer patients undergoing post-operative radiotherapy, and to analyze clinicodosimetric factors associated with acute RP. Methods: Between 2015 and 2017, 61 patients with breast cancer who underwent follow-up chest CT at 3 months after radiotherapy were analyzed. The degree of acute RP on CT was evaluated by the change of extent and scoring system (grade 0, no RP; Grade 1, ground-glass opacities (GGOs); Grade 2, GGOs and/or consolidations; Grade 3, clear focal consolidation; Grade 4, dense consolidation). The dosimetric parameters were calculated from the dose–volume histogram of RT. Results: The acute RP on CT was scored as follows: Grade 0, in 37.7%, Grade 1 in 13.1%, Grade 2 in 44.3%, and Grade 3 in 4.9%. The median extent of RP in patients with Grades 1 to 3 was 6.2 ml (range, 0.2–95.9). There were no clinicodosimetric factors significantly associated with the presence of RP or its severity. One patient developed symptomatic RP. Conclusion: This study showed no correlation between acute RP and clinicodosimetric factors, and acute RP based on CT findings were much more common than symptomatic RP. Advances in knowledge: CT findings of acute RP or extent of RP were not significantly related to clinicodosimetric factors in breast cancer patients. © 2021 The Authors. Published by the British Institute of Radiology