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Title
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Parametric response mapping of bronchiolitis obliterans syndrome progression after lung transplantation
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Author
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Abstract
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| Bronchiolitis obliterans syndrome (BOS) remains a major complication after lung transplantation. Air trapping and mosaic attenuation are typical radiological features of BOS; however, quantitative evaluation remains troublesome. We evaluated parametric response mapping (PRM, voxel-to-voxel comparison of inspiratory and expiratory computed tomography [CT] scans) in lung transplant recipients diagnosed with BOS (n = 20) and time-matched stable lung transplant recipients (n = 20). Serial PRM measurements were performed prediagnosis, at time of BOS diagnosis, and postdiagnosis (T-pre, T-0, and T-post, respectively), or at a postoperatively matched time in stable patients. PRM results were correlated with pulmonary function and confirmed by microCT analysis of end-stage explanted lung tissue. Using PRM, we observed an increase in functional small airway disease (fSAD), from T-pre to T-0 (p = 0.006) and a concurrent decrease in healthy parenchyma (p = 0.02) in the BOS group. This change in PRM continued to T-post, which was significantly different compared to the stable patients (p = 0.0002). At BOS diagnosis, the increase in fSAD was strongly associated with a decrease in forced expiratory volume in 1 s (p = 0.011). Micro-CT confirmed the presence of airway obliteration in a sample of a BOS patient identified with 67% fSAD by PRM. We demonstrated the use of PRM as an adequate output to monitor BOS progression in lung transplant recipients. |
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Language
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English
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Source (journal)
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American journal of transplantation. - Copenhagen
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Publication
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Copenhagen
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2016
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ISSN
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1600-6135
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DOI
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10.1111/AJT.13945
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Volume/pages
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16
:11
(2016)
, p. 3262-3269
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ISI
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000388204600025
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Pubmed ID
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27367568
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Full text (Publisher's DOI)
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