Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Radiation Recall Pneumonitis: Imaging Appearance and Differential Considerations

  • Nahyun Celina Jo (Department of Diagnostic Radiology, University of Texas Medical Branch) ;
  • Girish S. Shroff (Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center) ;
  • Jitesh Ahuja (Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center) ;
  • Rishi Agrawal (Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center) ;
  • Melissa C. Price (Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital) ;
  • Carol C. Wu (Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center)
  • Received : 2024.04.03
  • Accepted : 2024.07.24
  • Published : 2024.09.01
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Abstract

Radiation recall pneumonitis is an inflammatory reaction of previously radiated lung parenchyma triggered by systemic pharmacological agents (such as chemotherapy and immunotherapy) or vaccination. Patients present with non-specific symptoms such as cough, shortness of breath, or hypoxia soon after the initiation of medication or vaccination. Careful assessment of the patient's history, including the thoracic radiation treatment plan and timing of the initiation of the triggering agent, in conjunction with CT findings, contribute to the diagnosis. Once a diagnosis is established, treatment includes cessation of the causative medication and/or initiation of steroid therapy. Differentiating this relatively rare entity from other common post-therapeutic complications in oncology patients, such as recurrent malignancy, infection, or medication-induced pneumonitis, is essential for guiding downstream clinical management.

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References

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