Angiographic Findings in Patients with Hepatocellular Carcinoma Previously Treated Using Proton Beam Therapy

Figure 3

A 66-year-old man underwent his first proton beam therapy (PBT) treatment for hepatocellular carcinoma (HCC) in S8/1 48 months before the angiography procedure (1). Computed tomography revealed radiation-induced pneumonitis in the medial side of the right lower lung (2). An extrahepatic collateral pathway (via right inferior phrenic artery, RIPA) and an arteriovenous shunt for the pulmonary vein were noted during the procedure (3). The location of the arteriovenous shunt corresponded to the site of the radiation-induced pneumonitis.