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Filling In of Radiation Therapy–induced Bronchiectatic Change: A Reliable Sign of Locally Recurrent Lung Cancer

¹ Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Box 57, 1515 Holcombe Blvd, Houston, TX 77030.

PURPOSE: To determine if filling in of radiation therapy–induced bronchiectatic change is a reliable computed tomographic (CT) sign of locally recurrent lung cancer.

MATERIALS AND METHODS: The study included 28 patients who were free of disease and had stable radiation therapy–induced consolidation in ectatic bronchi at least 9 months after completion of radiation therapy for non–small cell lung cancer. Serial CT scans were retrospectively reviewed for evidence of local recurrence.

RESULTS: Filling in of previously patent ectatic bronchi occurred in the 20 patients with recurrent disease. Filling in was the first sign of recurrence in six patients (30%), was seen concurrently with other evidence of local recurrence in 11 (55%), and was seen after the occurrence of other signs in three (15%). Eight patients with stable radiation-induced fibrosis and patent bronchi remained disease free.

CONCLUSION: Filling in of radiation therapy–induced bronchiectatic change is a reliable CT sign of locally recurrent lung cancer.

Index terms: Bronchiectasis, 60.47, 60.26 • Lung, CT, 60.12112 • Lung neoplasms, 60.321, 60.323 • Lung neoplasms, therapeutic radiology, 60.1299 • Radiations, injurious effects, complications of therapeutic radiology, 60.47

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