Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

DOI: 10.1148/radiol.2312030563
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Konen, E.
Right arrow Articles by Weisbrod, G. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Konen, E.
Right arrow Articles by Weisbrod, G. L.
(Radiology 2004;231:467-473.)
© RSNA, 2004

Thoracic Imaging

Bronchiolitis Obliterans Syndrome in Lung Transplant Recipients: Can Thin-Section CT Findings Predict Disease before Its Clinical Appearance?1

Eli Konen, MD, Carlos Gutierrez, MD, MSc, Cecilia Chaparro, MD, Conor P. Murray, MD, TaeBong Chung, MD, Jane Crossin, MD, Michael A. Hutcheon, MD, FCCP, Narinder S. Paul, MD and Gordon L. Weisbrod, MD

1 From the Department of Medical Imaging (E.K., C.P.M., T.B.C., J.C., N.S.P., G.L.W.) and Toronto Lung Transplant Program (C.G., C.C., M.A.H.), Toronto General Hospital, University Health Network, Ontario, Canada. Received April 10, 2003; revision requested June 11; final revision received September 9; accepted September 29. Address correspondence to E.K., Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel (e-mail: konen@zahav.net.il).

PURPOSE: To determine whether there are thin-section computed tomographic (CT) features that predict bronchiolitis obliterans syndrome (BOS) in lung transplant recipients before the clinical appearance and during the early stages of the disease.

MATERIALS AND METHODS: Two hundred ninety-eight thin-section CT scans obtained in 26 lung transplant recipients who did (study group) and 26 lung transplant recipients who did not (control group) develop BOS were reviewed for the presence of mosaic perfusion, bronchiectasis, bronchial wall thickening, and air trapping. BOS was defined by using the recently revised definition of the International Society for Heart and Lung Transplantation. CT scans obtained in the BOS group were divided into three groups: Group A consisted of the last scans obtained before the clinical appearance of BOS; groups B and C consisted of, respectively, the first and last scans obtained after the clinical appearance of BOS. Scans obtained in the control group were acquired during similar posttransplantation periods and matched to scans in each BOS group. Sensitivity, specificity, and positive and negative predictive values were calculated separately for each subgroup. The optimal threshold for each thin-section CT–depicted abnormality was defined by using receiver operating characteristics analysis.

RESULTS: The sensitivities of air trapping for the diagnosis of BOS during the periods in which the scans in groups A, B, and C were obtained were 50%, 44%, and 64%, respectively; specificities were 80%, 100%, and 80% respectively. Sensitivities of mosaic perfusion were 4%, 20%, and 36%, respectively; specificities were 100%, 96%, and 96%, respectively. Sensitivities of bronchiectasis were 25%, 24%, and 32%, respectively; specificities were 80%, 80%, and 96%, respectively. Sensitivities of bronchial wall thickening were 4%, 24%, and 40%, respectively; specificities were 96%, 84%, and 80%, respectively. Air trapping was seen intermittently in nine (43%) of 21 patients with CT scans that depicted this finding at least once.

CONCLUSION: The value of the finding of air trapping before the clinical appearance and during the early stages of BOS is lower than has been previously reported. When using the recently revised criteria for BOS, the role of thin-section CT as a screening test to evaluate patients with lung transplants appears to be limited.

© RSNA, 2004

Index terms: Bronchiolitis obliterans, 60.2191 • Lung, CT, 60.12111, 60.12118 • Lung, diseases, 60.2191 • Lung, function • Lung, transplantation




This article has been cited by other articles:


Home page
 Am. J. Roentgenol.Home page
Y. Li Ng, N. Paul, D. Patsios, A. Walsham, T.-B. Chung, S. Keshavjee, and G. Weisbrod
Imaging of Lung Transplantation: Review
Am. J. Roentgenol., March 1, 2009; 192(3_Supplement): S1 - S13.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
Y. Li Ng, N. Paul, D. Patsios, A. Walsham, T.-B. Chung, S. Keshavjee, and G. Weisbrod
Imaging of Lung Transplantation: Self-Assessment Module
Am. J. Roentgenol., March 1, 2009; 192(3_Supplement): S14 - S19.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. B. Reece, J. D. Mitchell, M. R. Zamora, D. A. Fullerton, J. C. Cleveland, M. Pomerantz, D. M. Lyu, F. L. Grover, and M. J. Weyant
Native lung volume reduction surgery relieves functional graft compression after single-lung transplantation for chronic obstructive pulmonary disease.
J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 931 - 937.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
P A de Jong, J D Dodd, H O Coxson, C Storness-Bliss, P D Pare, J R Mayo, and R D Levy
Bronchiolitis obliterans following lung transplantation: early detection using computed tomographic scanning
Thorax, September 1, 2006; 61(9): 799 - 804.
[Abstract] [Full Text] [PDF]