Fluorine-18 FDG dual-head gamma camera coincidence imaging of radiation pneumonitis

A 69-year-old man with inoperable stage I squamous cell carcinoma of the lung underwent a radical course of radiotherapy combined with platinum-based chemotherapy. Fluorine-18 fluorodeoxyglucose (FDG) imaging with a dual-head coincidence gamma camera system (Co-PET) diagnosed radiation pneumonitis 1 month after completion of radiotherapy, when the clinical and radiographic signs were atypical and more suggestive of carcinomatous lymphangitis. Treatment with oral steroids was begun based on FDG scan findings, with prompt clinical benefit as would be expected for radiation pneumonitis.