Douglas Zaione Nascimento1, Guilherme Watte2, Felipe Soares Torres3, Sadi Marcelo Schio1, Leticia Sanchez1, Jackeline Larissa Mendes de Sousa1, Fabiola Adelia Perin1, Nupur Verma4, Tan-Lucien H Mohammed4, Bruno Hochhegger5. 1. Department of Lung Transplantation, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, Brazil. 2. Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020160, Brazil. g.watte@gmail.com. 3. Joint Department of Medical Imaging, University of Toronto, 585 University Avenue, 1 PMB 274, Toronto, ON, M5G2N2, Canada. 4. Department of Radiology, College of Medicine, University of Florida, Gainesville, FL, 32611, USA. 5. Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020160, Brazil.
Abstract
OBJECTIVE: To evaluate quantitative chest computed tomography (CT) methods for the detection of air trapping (AT) and to assess its diagnostic performance for the diagnosis of bronchiolitis obliterans syndrome (BOS) in single lung transplant (SLT) patients. METHODS: Adult patients who had a SLT at a single transplant center and underwent CT scan after transplantation were retrospectively included. CT findings of air trapping were measured by three different methods: expiratory air-trapping index (ATIexp), mean lung density on expiratory acquisition (MLDexp) and expiratory to inspiratory ratio of mean lung density (E/I-ratio(MLD). Sensitivity, specificity and diagnostic accuracy of the three methods for the detection of BOS status evaluated by serial routine measures of pulmonary function tests (gold standard) were assessed. RESULTS: Forty-six SLT patients (52.2% females, mean age 58 ± 6 years) were included in the analysis, 12 (26%) patients with a diagnosis of BOS. Quantitative CT diagnosis of AT ranged from 26 to 35%. Sensitivity, specificity and accuracy of each method for the detection of BOS were 85.7%, 84.7% and 85.0% for ATIexp, 78.5%, 93.4% and 90.0% for MLD and 64.2%, 89.1% and 83.3% E/I-ratio(MLD), respectively. CONCLUSION: Quantitative measures of AT obtained from standard CT are feasible and show high specificity and accuracy for the detection of BOS in SLT patients.
OBJECTIVE: To evaluate quantitative chest computed tomography (CT) methods for the detection of air trapping (AT) and to assess its diagnostic performance for the diagnosis of bronchiolitis obliterans syndrome (BOS) in single lung transplant (SLT) patients. METHODS: Adult patients who had a SLT at a single transplant center and underwent CT scan after transplantation were retrospectively included. CT findings of air trapping were measured by three different methods: expiratory air-trapping index (ATIexp), mean lung density on expiratory acquisition (MLDexp) and expiratory to inspiratory ratio of mean lung density (E/I-ratio(MLD). Sensitivity, specificity and diagnostic accuracy of the three methods for the detection of BOS status evaluated by serial routine measures of pulmonary function tests (gold standard) were assessed. RESULTS: Forty-six SLT patients (52.2% females, mean age 58 ± 6 years) were included in the analysis, 12 (26%) patients with a diagnosis of BOS. Quantitative CT diagnosis of AT ranged from 26 to 35%. Sensitivity, specificity and accuracy of each method for the detection of BOS were 85.7%, 84.7% and 85.0% for ATIexp, 78.5%, 93.4% and 90.0% for MLD and 64.2%, 89.1% and 83.3% E/I-ratio(MLD), respectively. CONCLUSION: Quantitative measures of AT obtained from standard CT are feasible and show high specificity and accuracy for the detection of BOS in SLT patients.
Entities:
Keywords:
Air trapping; Bronchiolitis obliterans syndrome; Computed tomography; Single lung transplant
Authors: Claus Neurohr; Patrick Huppmann; Dolores Thum; Werner Leuschner; Werner von Wulffen; Tobias Meis; Hanno Leuchte; Rainer Baumgartner; Gregor Zimmermann; Rudolf Hatz; Stephan Czerner; Lorenz Frey; Peter Ueberfuhr; Iris Bittmann; Juergen Behr Journal: Transpl Int Date: 2010-03-05 Impact factor: 3.782
Authors: J D Cooper; M Billingham; T Egan; M I Hertz; T Higenbottam; J Lynch; J Mauer; I Paradis; G A Patterson; C Smith Journal: J Heart Lung Transplant Date: 1993 Sep-Oct Impact factor: 10.247