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. 2018 Oct 4;17:1533033818801323. doi: 10.1177/1533033818801323

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© The Author(s) 2018

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

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Figure 5. — Computed tomography (CT) images from a 64-year-old woman with T2N0M0 adenocarcinoma who developed early fatal radiation pneumonitis that showed rapid progression. The patient had chronic heart failure, and CT performed before stereotactic body radiation therapy (SBRT) showed no pulmonary interstitial change. (A) The tumor shrank (a partial response), but strong dyspnea with diffuse interstitial pneumonitis appeared 40 days after the start of SBRT (B); the patient died 4 days later. The total (normal) lung volume receiving 20 Gy or more (V₂₀) was 5.0%, and the mean dose to the normal lung was 3.0 Gy.