{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:40Z","timestamp":1787017060792,"version":"build-2736575974"},"reference-count":21,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,2,9]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>\n                    We present the case of a patient with heavily pretreated metastatic castration-resistant prostate cancer (mCRPC) who received lutetium Lu-177 vipivotide tetraxetan (also known as\n                    <jats:sup>177<\/jats:sup>\n                    Lu-PSMA-617) due to progressive disease despite chemotherapy, hormonal therapy and radiation, including palliative mediastinal and central nervous system radiation. He was subsequently hospitalised for worsening acute onset dyspnoea despite clinically responding to therapy. Interval imaging revealed progressive multifocal ground-glass opacities superimposed on a background of underlying peribronchovascular fibrosis. Further workup, including an extensive workup to identify a possible infectious aetiology, ruled out most aetiologies leaving radiation pneumonitis (RP), radiation recall pneumonitis (RRP) and drug-induced pneumonitis as possible diagnoses secondary to\n                    <jats:sup>177<\/jats:sup>\n                    Lu -PSMA-617. The associated imaging findings of ground-glass opacities and consolidation can be like other aetiologies such as acute infection and subsequently may be treated incorrectly. In the use of theragnostics like\n                    <jats:sup>177<\/jats:sup>\n                    Lu -PSMA-617, it is fundamental to apply the practices of radioprotection learnt from radiotherapy, as well as to consider prior radiotherapy treatments and their possible side effects when used in conjunction.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2023-257772","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T11:50:51Z","timestamp":1708689051000},"page":"e257772","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Diffuse Pneumonitis after Lutetium-177-PSMA-617 Treatment in a Patient with Metastatic Castration-Resistant Prostate Cancer"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7191-0437","authenticated-orcid":false,"given":"John S","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Nuclear Medicine and Radiotheranostics, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trey C","family":"Mullikin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA"},{"name":"Duke Cancer Institute, Durham, North Carolina, USA"},{"name":"Center for Prostate & Urologic Cancers, Duke Cancer Institute, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"2025082802070752000_17.2.e257772.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"2025082802070752000_17.2.e257772.2","doi-asserted-by":"crossref","first-page":"2188","DOI":"10.1007\/s00259-023-06139-x","article-title":"Adoption of Lutetium-(177) PSMA Radioligand therapy for metastatic Castration resistant prostate cancer: a total population analysis in Germany from 2016 to 2020","volume":"50","author":"Flegar","year":"2023","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2025082802070752000_17.2.e257772.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30314-7"},{"key":"2025082802070752000_17.2.e257772.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107322"},{"key":"2025082802070752000_17.2.e257772.5","doi-asserted-by":"publisher","DOI":"10.1200\/jco.20.02759"},{"key":"2025082802070752000_17.2.e257772.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12890-020-01376-4","article-title":"Radiation-induced lung injury: Current evidence","volume":"21","author":"Arroyo-Hern\u00e1ndez","year":"2021","journal-title":"BMC Pulm Med"},{"key":"2025082802070752000_17.2.e257772.7","doi-asserted-by":"publisher","DOI":"10.7497\/j.issn.2095-3941.2012.03.009"},{"key":"2025082802070752000_17.2.e257772.8","first-page":"2338","article-title":"Differential effects of cytotoxic agents on hematopoietic progenitors","volume":"41","author":"Botnick","year":"1981","journal-title":"Cancer Res"},{"key":"2025082802070752000_17.2.e257772.9","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2019190036"},{"key":"2025082802070752000_17.2.e257772.10","doi-asserted-by":"crossref","unstructured":"Gafita A , et al . n.d. 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