Bleomycin Toxicity - Findings on FDG PET CT

Bleomycin, an antitumour antibiotic, is an essential part of treatment for multiple curable cancers, most commonly Hodgkin Lymphoma (HL) and germ cell tumours. Major limitation of its use is lung toxicity. Early diagnosis and treatment of bleomycin lung toxicity (BLT) is crucial, as the changes are reversible during early inflammatory phase only. 18F Flourodeoxyglucose (FDG) PET-CT can predict BLT early in the course of illness. It is important to pay attention to lung parenchymal uptake on interim and end of treatment scans, as this may predict lung toxicity even in the absence of morphological lung abnormalities and clinical symptoms.