Dynamic high-resolution electron-beam CT scanning for the diagnosis of bronchiolitis obliterans syndrome after lung transplantation

Friedrich D Knollmann, Susanne Kapell, Hans Lehmkuhl, Bernhard Schulz, Heidi Böttcher, Roland Hetzer, Roland Felix

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Purpose: To determine the diagnostic capabilities of dynamic high-resolution electron-beam (HREB) CT scanning for diagnosing bronchiolitis obliterans syndrome (BOS) in lung transplant recipients. Materials and methods: At the time of follow-up examinations after lung transplantation, 52 patients were examined by dynamic HREB CT scan. Visual signs of small airway disease were assessed and compared with lung function. For numerical analysis, the mean lung attenuation and its SD were determined and compared with the course of lung function tests. Results: On visual analysis, significant parenchymal attenuation inhomogeneities were present in eight of nine patients with manifest BOS, and in two of four patients who developed BOS during follow-up. Thirteen of 20 patients with persistent normal lung function displayed homogeneous lung attenuation. On numerical analysis, mean lung attenuation was significantly lower in patients who developed BOS during follow-up than in patients with persistent normal lung function (both in expiration and inspiration, p < 0.0001). With an optimal threshold, the sensitivity was 100% (4 of 4 patients) and the specificity was 90% (19 of 20 patients). In patients with BOS at the time of the CT scan examination, parenchymal attenuation was less homogeneous than in patients with persistent normal lung function (p < 0.0001). With an optimal threshold, the sensitivity was 78% (7 of 9 patients) and the specificity was 85% (17 of 20 patients). Conclusions: Dynamic HREB CT of lung transplant recipients correlates well with lung function criteria of BOS at the time of the CT examination and with the subsequent progression to BOS.

Original languageEnglish (US)
Pages (from-to)447-456
Number of pages10
JournalChest
Volume126
Issue number2
DOIs
StatePublished - Aug 2004
Externally publishedYes

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Keywords

  • Bronchiolitis obliterans
  • High-resolution CT scan
  • Lung CT scan
  • Lung transplantation
  • Quantitative CT scan

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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