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[Pulmonary reaction to radiation following mantle-field irradiation. Comparison of follow-up by conventional x-ray and by computed tomography].

A group of 36 patients who received mantle field irradiation for Hodgkin's disease (35 pts) or non-Hodgkin lymphoma (1 pt) were prospectively examined by plain film radiography and computed tomography (CT) for evaluation of the pulmonary reaction at the beginning and the end of the course of irradiation, and at 12 weeks, 17 weeks, and 37 weeks after the start of the mantle field irradiation. A total of 173 plain chest radiographs (p.a. and lateral view), and 167 CTs were reviewed. As in chest radiography, the pulmonary reaction to radiation seen in CT took a characteristic course with different distinguishable stages. The radiation-induced changes typically seen on on CT were reducible to three basic patterns of opacification, which sometimes appeared in combination, and had a characteristic spatial distribution. Comparison of the two imaging modalities suggest that CT should be used in special cases, while conventional plain film radiography of the chest, with the possibility of short-term controls, is still the mainstay of follow-up for patients with Hodgkin's disease.