الفهرس 
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Abstract
This study was carried out to identify the role of multidetector computerized tomography in assessment of acute post irradiation pulmonary changes. The study was conducted in Radiology Department of Alexandria University Hospital on 30 patients. Their age ranged from 29 to 72 years (mean = 48.8 years). These patients were 24 females and six males. All patients were referred from Oncology and Nuclear Medicine Department. They all had different types of malignancies for which they received radiotherapy. Plain x-ray chest PA view, spiral CT, high-resolution CT of the chest were done for all patients, and PET-CT was done for two patient. All patients were imaged within six months after the last day of radiation therapy.
This study included 16 patients with breast cancer , 12 patients with lung cancer and two patients with lymphoma.
We found that RILD in our study was more common at age group 40-50 years and common in female patients.
Different radiological pattern were found as ground-glass opacities(19 cases), consolidation with air-bronchogram(15 cases), atelectatic bands(7 cases), nodules(6 cases), fibrosis with traction bronchiectasis(14 cases) and pneumothorax(4 cases).BOOP-type pneumonia can occur after radiation therapy to the lung radiological findings showed patchy groundglass attenuation and consolidation mainly subpleural and peribronchial representing Atol sign which is highly specific to BOOP.
Areas of consolidation with air bronchogram and ground-glass opacities were the most common finding associated with early RILD (63.4%). Occurrence of RILD is not correlated with the presence of chest related symptoms.
According to the CT grading scale postirradiation changes detected in this study 5 cases(16.7%)representing with grade1, 6cases (20.0%)representing with grade 2, 9cases (30%)representing with grade 3, 10cases (33.0%)representing with grade 4.
Our study also showed the risk factors for RILD include dose factors as (V20-MLD) and non dose factors as (age, smoking, previous chemotherapy and underlying lung disease COPD)
Previous chemotherapy before irradiation was a risk factor for grade >2 of radiation pneumonitis. Pre-existing COPD appears to more susceptible to acute lung injury after radiotherapy. Patients with pre-existing chronic obstructive pulmonary disease (COPD) during CT scanning presented with findings that correspond to radiation-induced injury grade 3 and 4.
from this study we concluded that CT of the chest including HRCT of the lung is the modality of choice in assessment of early RILD.