Multi-detector Computed Tomography (MDCT) Findings of Chemotherapy-Induced Cardiopulmonary Changes

Purpose: To evaluate the role of multi-detector computed tomography (MDCT) in detection & characterization of chemotherapy-induced cardiopulmonary changes.

Materials and Methods: This retrospective study included 400 patients with confirmed 14 extra-pulmonary malignancies and treated by standard chemotherapy regimens. Of the 400 patients, 234 complained of Non Hodgkin lymphoma (NHL). Thirteen other types of malignant tumors were enrolled in our study. All patients underwent CT scan using 64 MDCT scanner (Brilliance 64, Philips) before chemotherapy and 6 months after the last session of chemotherapy. Chest CT scans were evaluated for ground-glass opacities (GGO), fibrosis, consolidation, nodules, pleural effusion, cardiac dilatation, pericardial effusion and pulmonary embolism.

Results: Cardiopulmonary chemotherapy-induced changes detected in 36/400 patients. The most common finding was pneumonic consolidation detected in 18/36. GGOs, fibrotic bands, pleural effusion and pericardial effusion were detected in 10/36, 6/36, 6/36 and 2/36 respectively. More than one finding detected in 6 patients. These changes completely resolved on follow-up without medication.

Conclusion: MDCT can accurately detect and evaluate cardiopulmonary chemotherapy-induced changes, differentiate these changes from disease progression and /or superadded pathology. Pneumonic consolidation is the commonest finding. Awareness of chemotherapy-induced cardiopulmonary changes can help the radiologist to detect these at early stages, which helps in appropriate management.