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

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