Imaging Manifestations Following Radiation Therapy for Lung Cancer

Taylor A Strange, Rishi Agrawal, Jitesh Ahuja, Melissa C Price, Mylene T Truong, Chad D Strange

Radiol Clin North Am. 2025 Jul;63(4):583-593. doi: 10.1016/j.rcl.2024.12.010. Epub 2025 Jan 9.

Abstract

Radiation therapy (RT) using conventional or newer high precision techniques, including 3-dimensional conformal radiotherapy, intensity-modulated RT, stereotactic body RT, and proton therapy, is an important component in the treatment of patients with lung cancer. Interpreting images for these patients requires knowledge of the radiation technique used, the expected temporal evolution of radiation-induced lung injury (RILI), and patient-specific parameters such as previous radiotherapy and concurrent chemoradiotherapy or immunotherapy. This review discusses factors that affect the development and severity of RILI and its radiologic manifestations, differences between conventional and high-precision dose radiotherapy techniques, and common complications following RT.