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Application of dual energy CT in the diagnosis of amiodarone lung toxicity as a cause of lung mass

  • Author Footnotes
    1 Authorship: Drafting the manuscript and revising the work.
    Tom Soker
    Correspondence
    Corresponding author at: University Hospital Cleveland Medical Center, Radiology Department, 11100 Euclid Avenue, Cleveland, OH 44106, United States of America.
    Footnotes
    1 Authorship: Drafting the manuscript and revising the work.
    Affiliations
    University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America
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  • Author Footnotes
    2 Authorship: Critical revision of the manuscript.
    Michael Yang
    Footnotes
    2 Authorship: Critical revision of the manuscript.
    Affiliations
    University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America
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  • Author Footnotes
    2 Authorship: Critical revision of the manuscript.
    Robert C. Gilkeson
    Footnotes
    2 Authorship: Critical revision of the manuscript.
    Affiliations
    University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America
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  • Author Footnotes
    2 Authorship: Critical revision of the manuscript.
    Kianoush Ansari-Gilani
    Footnotes
    2 Authorship: Critical revision of the manuscript.
    Affiliations
    University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America
    Search for articles by this author
  • Author Footnotes
    1 Authorship: Drafting the manuscript and revising the work.
    2 Authorship: Critical revision of the manuscript.

      Highlights

      • The presence of iodine in a mass-like consolidation suggests amiodarone toxicity.
      • Dual energy CT can provide better tissue characterization than conventional CT.
      • Dual energy CT has the potential to help differentiate amiodarone toxicity from lung malignancy.

      Abstract

      Background

      Diagnosis of amiodarone lung toxicity on computerized tomography (CT) can be challenging especially in the presence of mass-like consolidation. Additional causes of mass-like consolidation including malignancy and pneumonia should be excluded, sometimes requiring tissue sampling.

      Case

      Here we present a case of amiodarone lung toxicity, with diagnosis suspected based on patient's history of chronic cardiac disease, amiodarone treatment, and imaging characteristics. Evaluation with dual energy CT demonstrated high iodine content in the mass-like consolidation further supporting the diagnosis. Biopsy of the mass-like consolidation confirmed amiodarone toxicity.

      Conclusion

      Dual energy CT has potential utility in differentiating mass-like consolidation from other etiologies such as malignancy or pneumonia.

      Keywords

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