E2486. Post SBRT Lung Cancer Recurrence: A Case-Based Multimodality Pictorial Review Highlighting the Impact of PET CT on Patient Management
Authors
Joel Webb;
Rush University Medical Center
Pokhraj Suthar;
Rush University Medical Center
Sumeet Virmani;
Rush University Medical Center
Background
Stereotactic body radiation therapy (SBRT) is a common treatment modality for lung malignancy. Irradiated lung tissues develop a characteristic change in appearance, including ground-glass opacities, consolidations, fibrosis, and bronchiectasis or a combination of these. These expected findings may obscure the visualization of residual cancer or cancer recurrence. The imaging physician must be aware of different imaging patterns at various stages of healing after SBRT to aid in the early diagnosis of tumor recurrence. PET-CT is an important imaging modality to differentiate evolving post-radiation changes versus tumor recurrence.
Educational Goals / Teaching Points
In this exhibit, we highlight the importance of PET-CT in differentiating evolving post-radiation changes versus tumor recurrence. We also highlight the importance of PET in selecting the intended biopsy site (targeting the metabolically active area).
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We present 15 PET-CT studies with multimodality correlation when possible, highlighting the importance of PET-CT in differentiating evolving post-radiation changes versus tumor recurrence. Various imaging patterns at different stages of after SBRT treatment are also highlighted.
Conclusion
PET-CT is an important imaging tool to differentiate evolving post-radiation changes versus tumor recurrence. It can also help to select the intended biopsy site (targeting the metabolically active area).
