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Fig. 13 | Insights into Imaging

Fig. 13

From: Imaging side effects and complications of chemotherapy and radiation therapy: a pictorial review from head to toe

Fig. 13

Myocarditis associated to immune checkpoint inhibitor in a patient with lung cancer. A 67-year-old man with advanced lung adenocarcinoma (stage IIIB) was initially treated with ChT/RT. Axial CT image (a) showing right lung RT-related changes around the primitive cancer (arrow). Due to an incomplete response, treatment with immune checkpoint inhibitor was administered. The patient attended was admitted four months later at the emergency department for acute dyspnea associated to increased high sensitive troponin T (113 ng/L; normal value < 14 ng/L). Cardiac MR showed a left ventricle with normal volume (83 mL/m2) but with a slight depression of the ejection fraction (47%) associated to a diffuse hyperintensity on STIR image and increased T2-ratio (b) suggestive for diffuse edema and a shadowed late gadolinium enhancement in the inferior wall with non-ischemic pattern. MR findings indicated active myocarditis which was confirmed at endomyocardial biopsy

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