Effects of radiation therapy on the lung: Radiologic appearances and differential diagnosis

Yo Won Choi, Reginald F. Munden, Jeremy J. Erasmus, Kyung Joo Park, Woo Kyung Chung, Seok Chol Jeon, Choong Ki Park

Research output: Contribution to journalReview articlepeer-review

245 Scopus citations


Radiation-induced lung disease (RILD) due to radiation therapy is common. Radiologic manifestations are usually confined to the lung tissue within the radiation port and are dependent on the interval after completion of treatment. In the acute phase, RILD typically manifests as ground-glass opacity or attenuation or as consolidation; in the late phase, it typically manifests as traction bronchiectasis, volume loss, and scarring. However, the use of oblique beam angles and the development of newer irradiation techniques such as three-dimensional conformal radiation therapy can result in an unusual distribution of these findings. Awareness of the atypical manifestations of RILD can be useful in preventing confusion with infection, recurrent malignancy, lymphangitic carcinomatosis, and radiation-induced tumors. In addition, knowledge of radiologic findings that are outside the expected pattern for RILD can be useful in diagnosis of infection or recurrent malignancy. Such findings include the late appearance or enlargement of a pleural effusion; development of consolidation, a mass, or cavitation; and occlusion of bronchi within an area of radiation-induced fibrosis. A comprehensive understanding of the full spectrum of these manifestations is important to facilitate diagnosis and management in cancer patients treated with radiation therapy.

Original languageEnglish (US)
Pages (from-to)985-997
Number of pages13
Issue number4
StatePublished - 2004


  • Lung neoplasms, therapeutic radiology, 60.1299, 60.32
  • Lung, effects of irradiation on, 60.47
  • Radiations, injurious effects, complications of therapeutic radiology, 60.47

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology


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