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While the short-term effects of hepatopulmonary shunting are well-defined, long-term complications have not been explored in the literature. We discuss the finding of multifocal interstitial pulmonary fibrosis in a patient treated with Y-90 for hepatocellular carcinoma. The reticular opacities were identified on chest CT scans seven months after the procedure and continued to consolidate up to 75 months post-radioembolization. Pathology confirmed multifocal fibrosis associated with Y-90 beads. This happened despite a low LSF and in the absence of clinical evidence of post-treatment radiation pneumonitis or chronic interstitial lung disease. This case report identifies radiation fibrosis as a differential diagnostic consideration when working up post-radioembolization patients with unexplained reticular opacities on lung imaging.<\/jats:p>","DOI":"10.1177\/10668969251333112","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:00:33Z","timestamp":1745467233000},"page":"1686-1693","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Multifocal Pulmonary Fibrosis Associated with Y-90 Embolization: A Case Report and Literature Review"],"prefix":"10.1177","volume":"33","author":[{"given":"Elizabeth (Lizzy)","family":"Kruse","sequence":"first","affiliation":[{"name":"University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Kim","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford","family":"Bemiss","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishant","family":"Parekh","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjana","family":"Yeldandi","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7599-6162","authenticated-orcid":false,"given":"Mohamed","family":"Amgad","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/abbc80"},{"key":"e_1_3_3_3_2","unstructured":"Boston Scientific (Accessed 2\/3\/2025). https:\/\/www.bostonscientific.com\/en-US\/medical-specialties\/interventional-radiology\/interventional-oncology\/therasphere\/dosage-and-administration.html"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201310-359CR"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-019-04517-y"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12149-022-01810-z"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30010-2"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201508-1550IM"},{"key":"e_1_3_3_9_2","first-page":"293","article-title":"Clinical evaluation of the partition model for estimating radiation doses from yttrium-90 microspheres in the treatment of hepatic cancer","volume":"24","author":"Ho S","year":"1997","unstructured":"Ho S, Lau WY, Leung TW, Chan M, Johnson PJ, Li AK. 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