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Case Reports
. 2016 Sep;50(3):261-5.
doi: 10.1007/s13139-015-0388-3. Epub 2015 Dec 22.

Role of (18)F-FDG PET-CT in Monitoring the Cyclophosphamide Induced Pulmonary Toxicity in Patients with Breast Cancer - 2 Case Reports

Sameer Kamalakar Taywade  1 , Rakesh Kumar  1 , Sainath Bhethanabhotla  2 , Chandrasekhar Bal  1
Affiliations
Case Reports

Role of (18)F-FDG PET-CT in Monitoring the Cyclophosphamide Induced Pulmonary Toxicity in Patients with Breast Cancer - 2 Case Reports

Sameer Kamalakar Taywade et al. Nucl Med Mol Imaging. 2016 Sep.

Abstract

Drug induced pulmonary toxicity is not uncommon with the use of various chemotherapeutic agents. Cyclophosphamide is a widely used chemotherapeutic drug in the treatment of breast cancer. Although rare, lung toxicity has been reported with cyclophosphamide use. Detection of bleomycin induced pulmonary toxicity and pattern of (18)F-fluorodeoxyglucose ((18)F-FDG) uptake in lungs on fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) has been elicited in literature in relation to lymphoma. However, limited data is available regarding the role of (18)F-FDG PET-CT in monitoring drug induced pulmonary toxicity in breast cancer. We here present two cases of cyclophosphamide induced drug toxicity. Interim (18)F-FDG PET-CT demonstrated diffusely increased tracer uptake in bilateral lung fields in both these patients. Subsequently there was resolution of lung uptake on (18)F-FDG PET-CT scan post completion of chemotherapy. These patients did not develop significant respiratory symptoms during chemotherapy treatment and in follow up.

Keywords: 18F-FDG PETCT; Carcinoma breast; Cyclophosphamide; Drug induced; Pulmonary toxicity.

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Figures

Fig. 1
Fig. 1
18F-FDG PET-CT: pretherapy 18F-FDG PET-CT (a,b,c) showed primary lesion in the right breast with intense 18F-FDG uptake. There was no abnormal 18F-FDG uptake in bilateral lungs. Interim 18F-FDG PET-CT (d,e,f) demonstrated decrease in size and radiotracer uptake in the primary with diffuse 18F-FDG uptake in the lungs more prominent in bilateral in subpleural areas. Post therapy 18F-FDG PET-CT showed persistent primary in right breast (g), with resolution of uptake in the bilateral lung field (h, i)
Fig. 2
Fig. 2
18F-FDG PET-CT: pretherapy 18F-FDG PET-CT (a,b,c) showed primary in left breast with intense 18F-FDG uptake. There was no abnormal 18F-FDG uptake in bilateral lungs. Interim 18F-FDG PET-CT (d,e,f) demonstrated decrease in size and radiotracer uptake in the primary lesion with diffusely increased 18F-FDG uptake in the lungs. Post therapy 18F-FDG PET-CT (g, h, i) showed persistent primary in left breast with resolution of uptake in the bilateral lung fields
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