TY - JOUR
TI - Lung hyperinflation quantitated by chest CT in children with bronchiolitis obliterans syndrome following allogeneic hematopoietic cell transplantation
AU - Moutafidis, D.
AU - Gavra, M.
AU - Golfinopoulos, S.
AU - Oikonomopoulou, C.
AU - Kitra, V.
AU - Woods, J.C.
AU - Kaditis, A.G.
JO - Clinical Imaging
PY - 2021
VL - 75
TODO - null
SP - 97-104
PB - HANLEY & BELFUS-ELSEVIER INC
SN - 0899-7071
TODO - 10.1016/j.clinimag.2021.01.011
TODO - Diagnosis;  Disease control;  Stem cells, Airway obstruction;  Based on detections;  Control subject;  Exponential models;  Hematopoietic cell;  Hematopoietic stem cell transplantation;  Small airways;  Total lung capacities, Biological organs, adolescent;  age;  allogeneic hematopoietic stem cell transplantation;  Article;  bronchiolitis obliterans;  bronchiolitis obliterans syndrome;  child;  clinical article;  computer assisted tomography;  controlled study;  female;  forced expiratory volume;  forced vital capacity;  human;  hyperinflation;  lung parenchyma;  lung volume;  male;  patient referral;  pediatric patient;  priority journal;  radiation attenuation;  retrospective study;  spirometry;  total lung capacity;  adverse event;  bronchiolitis obliterans;  diagnostic imaging;  hematopoietic stem cell transplantation;  lung;  lung transplantation;  x-ray computed tomography, Adolescent;  Bronchiolitis Obliterans;  Child;  Forced Expiratory Volume;  Hematopoietic Stem Cell Transplantation;  Humans;  Lung;  Lung Transplantation;  Retrospective Studies;  Tomography, X-Ray Computed
TODO - Objectives: Bronchiolitis obliterans syndrome (BOS) diagnosis in children following allogeneic hematopoietic stem cell transplantation (post-HSCT) is based on detection of airway obstruction on spirometry and air-trapping, small airway thickening or bronchiectasis on chest CT. We assessed the relationship between spirometry indices and low-attenuation lung volume at total lung capacity (TLC) on CT. Methods: Data of children post-HSCT with and without BOS were analyzed. An age-specific, low-attenuation threshold (LAT) was defined as average of (mean-1SD) lung parenchyma attenuation of 5 control subjects without lung disease matched to each age subgroup of post-HSCT patients. % CT lung volume at TLC with attenuation values <LAT was calculated. Association between % lung volume with low attenuation and FEV1/FVC was assessed. Results: Twenty-nine children post-HSCT were referred to exclude BOS and 12 of them had spirometry and an analyzable chest CT. We studied: (i) 6 children post-HSCT/BOS (median age: 8.5 years [IQR 7, 15]; median FEV1/FVC z-score: -2.60 [IQR -2.93, −2.14]); (ii) 6 children post-HSCT/no BOS (age: 13.5 years [9.8, 16.3]; FEV1/FVC z-score: 0.44 [−0.30, 2.10]); and (iii) 40 controls without lung disease (age:11 years [8.3, 15.8]). Patients post-HSCT/BOS had significantly higher % lung volume with low attenuation than patients post-HSCT/no BOS: median % volume 16.4% (7.1%, 37.2%) vs. 0.61% (0.34%, 2.79%), respectively; P = .004. An exponential model described the association between % CT lung volume below LAT and FEV1/FVC z-score (r2 = 0.76; P < .001). Conclusion: In children post-HSCT with BOS, low-attenuation lung volume on chest CT is associated with airway obstruction severity as expressed by FEV1/FVC z-score. © 2021 Elsevier Inc.
ER -