Skip to main content
Erschienen in: Lung 1/2021

13.01.2021 | LUNG TRANSPLANTATION

Utilization of Quantitative Computed Tomography Assessment to Identify Bronchiolitis Obliterans Syndrome After Single Lung Transplantation

verfasst von: Douglas Zaione Nascimento, Guilherme Watte, Felipe Soares Torres, Sadi Marcelo Schio, Leticia Sanchez, Jackeline Larissa Mendes de Sousa, Fabiola Adelia Perin, Nupur Verma, Tan-Lucien H. Mohammed, Bruno Hochhegger

Erschienen in: Lung | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Verleden GM, Raghu G, Meyer KC, Glanville AR, Corris P (2014) A new classification system for chronic lung allograft dysfunction. J Heart Lung Transplant 33:127–33CrossRef Verleden GM, Raghu G, Meyer KC, Glanville AR, Corris P (2014) A new classification system for chronic lung allograft dysfunction. J Heart Lung Transplant 33:127–33CrossRef
2.
Zurück zum Zitat Verleden SE, Vos R, Vandermeulen E, Ruttens D, Bellon H, Heigl T et al (2016) Parametric response mapping of bronchiolitis obliterans syndrome progression after lung transplantation. Am J Transplant 16:3262–3269CrossRef Verleden SE, Vos R, Vandermeulen E, Ruttens D, Bellon H, Heigl T et al (2016) Parametric response mapping of bronchiolitis obliterans syndrome progression after lung transplantation. Am J Transplant 16:3262–3269CrossRef
3.
Zurück zum Zitat Dettmer S, Suhling H, Klingenberg I, Otten O, Kaireit T, Fuge J et al (2018) Lobe-wise assessment of lung volume and density distribution in lung transplant patients and value for early detection of Bronchiolitis Obliterans Syndrome. Eur J Radiol. 106:137–44CrossRef Dettmer S, Suhling H, Klingenberg I, Otten O, Kaireit T, Fuge J et al (2018) Lobe-wise assessment of lung volume and density distribution in lung transplant patients and value for early detection of Bronchiolitis Obliterans Syndrome. Eur J Radiol. 106:137–44CrossRef
4.
Zurück zum Zitat Arcasoy SM, Kotloff RM. Lung transplantation. N Eng J Med. 1999; 340: 1081–91. Arcasoy SM, Kotloff RM. Lung transplantation. N Eng J Med. 1999; 340: 1081–91.
5.
Zurück zum Zitat Meyer KC, Raghu G, Verleden GM, Corris PA, Aurora P, Wilson KC et al (2014) An international ISHLT/ATS/ERS clinical practice guideline: diagnosis and management of bronchiolitis obliterans syndrome. Eur Respir J 44(6):1479–1503CrossRef Meyer KC, Raghu G, Verleden GM, Corris PA, Aurora P, Wilson KC et al (2014) An international ISHLT/ATS/ERS clinical practice guideline: diagnosis and management of bronchiolitis obliterans syndrome. Eur Respir J 44(6):1479–1503CrossRef
6.
Zurück zum Zitat Cooper JD, Billingham M, Egan T, Hertz MI, Higenbottam T, Lynch J et al (1993) A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts. International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 12:713–16PubMed Cooper JD, Billingham M, Egan T, Hertz MI, Higenbottam T, Lynch J et al (1993) A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts. International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 12:713–16PubMed
7.
Zurück zum Zitat Chamberlain D, Maurer J, Chaparro C, Idolor L (1994) Evaluation of transbronchial lung biopsy specimens in the diagnosis of bronchiolitis obliterans after lung transplantation. J Heart Lung Transplant 13(6):963–971PubMed Chamberlain D, Maurer J, Chaparro C, Idolor L (1994) Evaluation of transbronchial lung biopsy specimens in the diagnosis of bronchiolitis obliterans after lung transplantation. J Heart Lung Transplant 13(6):963–971PubMed
8.
Zurück zum Zitat Subramanian MP, Meyres BF (2018) Bilateral versus single lung transplantation: are two lungs better than one? J Thorac Dis 10(7):4588–4601CrossRef Subramanian MP, Meyres BF (2018) Bilateral versus single lung transplantation: are two lungs better than one? J Thorac Dis 10(7):4588–4601CrossRef
9.
Zurück zum Zitat Schaffer JM, Singh SK, Reitz BA, Zamanian RT, Mallidi HR (2015) Single- vs double-lung transplantation in patients with chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis since the implementation of lung allocation based on medical need. JAMA 313(9):936–948CrossRef Schaffer JM, Singh SK, Reitz BA, Zamanian RT, Mallidi HR (2015) Single- vs double-lung transplantation in patients with chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis since the implementation of lung allocation based on medical need. JAMA 313(9):936–948CrossRef
10.
Zurück zum Zitat Hadjiliadis D, Angel LF (2006) Controversies in lung transplantation: are two lungs better than one? Semin Respir Crit Care Med 27:561–566CrossRef Hadjiliadis D, Angel LF (2006) Controversies in lung transplantation: are two lungs better than one? Semin Respir Crit Care Med 27:561–566CrossRef
11.
Zurück zum Zitat Anyanwu AC, Rogers CA, Murday AJ (2000) Does Splitting the lung block into two single lung- grafts equate to doubling the societal benefit from bilateral lung donors? Comparisons between two single versus one bilateral lung transplant. Transpl Int 13:S201–S202CrossRef Anyanwu AC, Rogers CA, Murday AJ (2000) Does Splitting the lung block into two single lung- grafts equate to doubling the societal benefit from bilateral lung donors? Comparisons between two single versus one bilateral lung transplant. Transpl Int 13:S201–S202CrossRef
12.
Zurück zum Zitat Gerbase MW, Spiliopoulos A, Rochat T, Archinard M, Nicod LP (2005) Health-related quality of life following single or bilateral lung transplantation. Chest 128:1371–1378CrossRef Gerbase MW, Spiliopoulos A, Rochat T, Archinard M, Nicod LP (2005) Health-related quality of life following single or bilateral lung transplantation. Chest 128:1371–1378CrossRef
13.
Zurück zum Zitat Neurohr C, Huppmann P, Thum D, Leuschner W, von Wulffen W, Meis T et al (2010) Potential functional and survival benefit of double over single lung transplantation for selected patients with idiopathic pulmonary fibrosis. Transpl Int 23:887–896PubMed Neurohr C, Huppmann P, Thum D, Leuschner W, von Wulffen W, Meis T et al (2010) Potential functional and survival benefit of double over single lung transplantation for selected patients with idiopathic pulmonary fibrosis. Transpl Int 23:887–896PubMed
14.
Zurück zum Zitat Ng YL, Paul N, Patsios D, Walsham A, Chung TB, Keshavjee S, et al (2009) Imaging of lung transplantation: review. AJR Am J Roentgenol 192(3 Suppl):S1–S19 Ng YL, Paul N, Patsios D, Walsham A, Chung TB, Keshavjee S, et al (2009) Imaging of lung transplantation: review. AJR Am J Roentgenol 192(3 Suppl):S1–S19
15.
Zurück zum Zitat Busacker A, Newell JD Jr, Keefe T, Hoffman EA, Granroth JC, Castro M, et al (2009) A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis. Chest 135:48–56 Busacker A, Newell JD Jr, Keefe T, Hoffman EA, Granroth JC, Castro M, et al (2009) A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis. Chest 135:48–56
16.
Zurück zum Zitat Kauczor HU, Wielpütz MO, Owsijewitsch M, Ley-Zaporozhan J (2011) Computed tomographic imaging of the airways in COPD and asthma. J Thorac Imaging 26(4):290–300CrossRef Kauczor HU, Wielpütz MO, Owsijewitsch M, Ley-Zaporozhan J (2011) Computed tomographic imaging of the airways in COPD and asthma. J Thorac Imaging 26(4):290–300CrossRef
17.
Zurück zum Zitat Hansell DM, Bankier AA, MacMahon McLoud TC, Muller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246(3):697–722CrossRef Hansell DM, Bankier AA, MacMahon McLoud TC, Muller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246(3):697–722CrossRef
18.
Zurück zum Zitat Solyanik O, Hollmann P, Dettmer S, Kaireit T, Schaefer-Prokop C, Wacker F et al (2015) Quantification of pathologic air trapping in lung transplant patients using CT density mapping: Comparison with other CT air trapping measures. PLoS ONE 10:e0139102CrossRef Solyanik O, Hollmann P, Dettmer S, Kaireit T, Schaefer-Prokop C, Wacker F et al (2015) Quantification of pathologic air trapping in lung transplant patients using CT density mapping: Comparison with other CT air trapping measures. PLoS ONE 10:e0139102CrossRef
19.
Zurück zum Zitat Konen E, Gutierrez C, Chaparro C, Murray CP, Chung T, Crossin J et al (2004) Bronchiolitis obliterans syndrome in lung transplant recipients: can thinsection CT findings predict disease before its clinical appearance? Radiology 231:467–473CrossRef Konen E, Gutierrez C, Chaparro C, Murray CP, Chung T, Crossin J et al (2004) Bronchiolitis obliterans syndrome in lung transplant recipients: can thinsection CT findings predict disease before its clinical appearance? Radiology 231:467–473CrossRef
20.
Zurück zum Zitat Berstad AE, Aaløkken TM, Kolbenstvedt A, Bjortuft O (2006) Performance of long-term CT monitoring in diagnosing bronchiolitis obliterans after lung transplantation. Eur J Radiol 58:124–131CrossRef Berstad AE, Aaløkken TM, Kolbenstvedt A, Bjortuft O (2006) Performance of long-term CT monitoring in diagnosing bronchiolitis obliterans after lung transplantation. Eur J Radiol 58:124–131CrossRef
21.
Zurück zum Zitat Lee ES, Gotway MB, Reddy GP, Golden JA, Keith FM, Webb WR (2000) Early bronchiolitisobliteransfollowinglungtransplantation: accuracy of expiratory thin-section CT for diagnosis. Radiology 216:472–477CrossRef Lee ES, Gotway MB, Reddy GP, Golden JA, Keith FM, Webb WR (2000) Early bronchiolitisobliteransfollowinglungtransplantation: accuracy of expiratory thin-section CT for diagnosis. Radiology 216:472–477CrossRef
22.
Zurück zum Zitat Eda S, Kubo K, Fujimoto K, Matsuzawa Y, Sekiguchi M, Sakai F (1997) The relations between expiratory chest CT using helical CT and pulmonary function tests in emphysema. Am J Respir Crit Care Med 155:1290–1294CrossRef Eda S, Kubo K, Fujimoto K, Matsuzawa Y, Sekiguchi M, Sakai F (1997) The relations between expiratory chest CT using helical CT and pulmonary function tests in emphysema. Am J Respir Crit Care Med 155:1290–1294CrossRef
23.
Zurück zum Zitat Mets OM, Isgum I, Mol CP, Gietema HA, Zanen P, Prokop M et al (2012) Variation in quantitative CT air trapping in heavy smokers on repeat CT examinations. Eur Radiol 22:2710–2717CrossRef Mets OM, Isgum I, Mol CP, Gietema HA, Zanen P, Prokop M et al (2012) Variation in quantitative CT air trapping in heavy smokers on repeat CT examinations. Eur Radiol 22:2710–2717CrossRef
24.
Zurück zum Zitat American Thoracic Society European Respiratory Society American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am J Respir Crit Care Med 2002; 165(2): 277–304 American Thoracic Society European Respiratory Society American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am J Respir Crit Care Med 2002; 165(2): 277–304
25.
Zurück zum Zitat Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R (2005) Interpretative strategies for lung function tests. Eur Respir J 26(5):948–968CrossRef Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R (2005) Interpretative strategies for lung function tests. Eur Respir J 26(5):948–968CrossRef
26.
Zurück zum Zitat Pereira CA, Sato T, Rodrigues SC (2007) New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol 33(4):397–406CrossRef Pereira CA, Sato T, Rodrigues SC (2007) New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol 33(4):397–406CrossRef
27.
Zurück zum Zitat Burton CM, Carlsen J, Mortensen J, Andersen CB, Milman N, Iversen M (2007) Long-term survival after lung transplantation depends on development and severity of bronchiolitis obliterans syndrome. J Heart Lung Transplant 26(7):681–686CrossRef Burton CM, Carlsen J, Mortensen J, Andersen CB, Milman N, Iversen M (2007) Long-term survival after lung transplantation depends on development and severity of bronchiolitis obliterans syndrome. J Heart Lung Transplant 26(7):681–686CrossRef
28.
Zurück zum Zitat Kapila A, Baz MA, Valentine VG, Bhorade SM, AIRSAC Investigators (2015) Reliability of diagnostic criteria for bronchiolitis obliterans syndrome after lung transplantation: a survey. J Heart Lung Transplant 34(1):65–74 Kapila A, Baz MA, Valentine VG, Bhorade SM, AIRSAC Investigators (2015) Reliability of diagnostic criteria for bronchiolitis obliterans syndrome after lung transplantation: a survey. J Heart Lung Transplant 34(1):65–74
29.
Zurück zum Zitat Matsuoka S, Kurihara Y, Yagihashi K, Hoshino M, Watanabe N, Nakajima Y (2008) Quantitative assessment of air trapping in chronic obstructive pulmonar disease using inspiratory and expiratory volumetric MDCT. AJR Am J Roentgenol 190(3):762–769CrossRef Matsuoka S, Kurihara Y, Yagihashi K, Hoshino M, Watanabe N, Nakajima Y (2008) Quantitative assessment of air trapping in chronic obstructive pulmonar disease using inspiratory and expiratory volumetric MDCT. AJR Am J Roentgenol 190(3):762–769CrossRef
30.
Zurück zum Zitat Bankier AA, Van Muylem A, Knoop C, Estenne M, Gevenois PA (2001) Bronchiolitis obliterans syndrome in heart-lung transplant recipients: diagnosis with expiratory CT. Radiology 218:533–539CrossRef Bankier AA, Van Muylem A, Knoop C, Estenne M, Gevenois PA (2001) Bronchiolitis obliterans syndrome in heart-lung transplant recipients: diagnosis with expiratory CT. Radiology 218:533–539CrossRef
31.
Zurück zum Zitat Siegel MJ, Bhalla S, Gutierrez FR, Hildebolt C, Sweet S (2001) Post-lung transplantation bronchiolitis obliterans syndrome: usefulness of expiratory thin-section CT for diagnosis. Radiology. 220:455–62CrossRef Siegel MJ, Bhalla S, Gutierrez FR, Hildebolt C, Sweet S (2001) Post-lung transplantation bronchiolitis obliterans syndrome: usefulness of expiratory thin-section CT for diagnosis. Radiology. 220:455–62CrossRef
32.
Zurück zum Zitat Leung AN, Fisher K, Valentine V, Girgis RE, Berry GJ, Robbins RC et al (1998) Bronchiolitis obliterans after lung transplantation: detection using expiratory HRCT. Chest 113:365–370CrossRef Leung AN, Fisher K, Valentine V, Girgis RE, Berry GJ, Robbins RC et al (1998) Bronchiolitis obliterans after lung transplantation: detection using expiratory HRCT. Chest 113:365–370CrossRef
33.
Zurück zum Zitat Belloli EA, Degtiar I, Wang X, Yanik GA, Stuckey LJ, Verleden SE et al (2017) Parametric Response Mapping as an Imaging Biomarker in Lung Transplant Recipients. Am J Respir Crit Care Med 195:942–952CrossRef Belloli EA, Degtiar I, Wang X, Yanik GA, Stuckey LJ, Verleden SE et al (2017) Parametric Response Mapping as an Imaging Biomarker in Lung Transplant Recipients. Am J Respir Crit Care Med 195:942–952CrossRef
Metadaten
Titel
Utilization of Quantitative Computed Tomography Assessment to Identify Bronchiolitis Obliterans Syndrome After Single Lung Transplantation
verfasst von
Douglas Zaione Nascimento
Guilherme Watte
Felipe Soares Torres
Sadi Marcelo Schio
Leticia Sanchez
Jackeline Larissa Mendes de Sousa
Fabiola Adelia Perin
Nupur Verma
Tan-Lucien H. Mohammed
Bruno Hochhegger
Publikationsdatum
13.01.2021
Verlag
Springer US
Erschienen in
Lung / Ausgabe 1/2021
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-020-00417-3

Weitere Artikel der Ausgabe 1/2021

Lung 1/2021 Zur Ausgabe

VAPING AND NONTUBERCULOUS MYCOBACTERIAL INFECTION

Vaping Associated Pulmonary Nontuberculous Mycobacteria

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.