Early bronchiolitis obliterans following lung transplantation: Accuracy of expiratory thin-section CT for diagnosis

Ell Seong Lee, Michael Gotway, Gautham P. Reddy, Jeffrey A. Golden, Fraser M. Keith, W. Richard Webb

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

PURPOSE: To evaluate the accuracy of thin-section computed tomography (CT) with expiratory scans in diagnosing early bronchiolitis obliterans after lung transplantation. MATERIALS AND METHODS: Thin-section CT scans were reviewed by two observers blinded to the diagnoses in seven consecutive lung transplant recipients with histopathologically proved bronchiolitis obliterans (group A) and 21 with normal biopsy findings (group B). All patients had normal biopsy and stable pulmonary function test (PFT) results 2-36 weeks prior to CT. Patients with normal biopsy results were placed into subgroups based on abnormal (group B1) or stable (group B2) PFT results. Air- trapping extent on expiratory scans was scored on a 24-point scale. RESULTS: The mean air-trapping score in group A (6.6) was not significantly different from that in group B (4.5, P = .17). The air-trapping score was significantly higher in groups A and B1 than in group B2 (6.2 and 2.6, respectively; P = .03). The frequency of an air-trapping score of 3 or more in groups A and B1 was significantly higher than that in group B2 (P = .03). By using a score of 3 or more to indicate air trapping, the sensitivity of expiratory CT was 74%, specificity was 67%, and accuracy was 71%. CONCLUSION: Thin-section CT, including expiratory scans, is of limited accuracy in diagnosing early bronchiolitis obliterans after lung transplantation.

Original languageEnglish (US)
Pages (from-to)472-477
Number of pages6
JournalRadiology
Volume216
Issue number2
StatePublished - Aug 2000
Externally publishedYes

Fingerprint

Bronchiolitis Obliterans
Lung Transplantation
Air
Tomography
Respiratory Function Tests
Biopsy
Lung

Keywords

  • Bronchi, CT
  • Bronchiolitis obliterans
  • Lung, biopsy
  • Lung, transplantation

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Lee, E. S., Gotway, M., Reddy, G. P., Golden, J. A., Keith, F. M., & Webb, W. R. (2000). Early bronchiolitis obliterans following lung transplantation: Accuracy of expiratory thin-section CT for diagnosis. Radiology, 216(2), 472-477.

Early bronchiolitis obliterans following lung transplantation : Accuracy of expiratory thin-section CT for diagnosis. / Lee, Ell Seong; Gotway, Michael; Reddy, Gautham P.; Golden, Jeffrey A.; Keith, Fraser M.; Webb, W. Richard.

In: Radiology, Vol. 216, No. 2, 08.2000, p. 472-477.

Research output: Contribution to journalArticle

Lee, ES, Gotway, M, Reddy, GP, Golden, JA, Keith, FM & Webb, WR 2000, 'Early bronchiolitis obliterans following lung transplantation: Accuracy of expiratory thin-section CT for diagnosis', Radiology, vol. 216, no. 2, pp. 472-477.
Lee, Ell Seong ; Gotway, Michael ; Reddy, Gautham P. ; Golden, Jeffrey A. ; Keith, Fraser M. ; Webb, W. Richard. / Early bronchiolitis obliterans following lung transplantation : Accuracy of expiratory thin-section CT for diagnosis. In: Radiology. 2000 ; Vol. 216, No. 2. pp. 472-477.
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abstract = "PURPOSE: To evaluate the accuracy of thin-section computed tomography (CT) with expiratory scans in diagnosing early bronchiolitis obliterans after lung transplantation. MATERIALS AND METHODS: Thin-section CT scans were reviewed by two observers blinded to the diagnoses in seven consecutive lung transplant recipients with histopathologically proved bronchiolitis obliterans (group A) and 21 with normal biopsy findings (group B). All patients had normal biopsy and stable pulmonary function test (PFT) results 2-36 weeks prior to CT. Patients with normal biopsy results were placed into subgroups based on abnormal (group B1) or stable (group B2) PFT results. Air- trapping extent on expiratory scans was scored on a 24-point scale. RESULTS: The mean air-trapping score in group A (6.6) was not significantly different from that in group B (4.5, P = .17). The air-trapping score was significantly higher in groups A and B1 than in group B2 (6.2 and 2.6, respectively; P = .03). The frequency of an air-trapping score of 3 or more in groups A and B1 was significantly higher than that in group B2 (P = .03). By using a score of 3 or more to indicate air trapping, the sensitivity of expiratory CT was 74{\%}, specificity was 67{\%}, and accuracy was 71{\%}. CONCLUSION: Thin-section CT, including expiratory scans, is of limited accuracy in diagnosing early bronchiolitis obliterans after lung transplantation.",
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N2 - PURPOSE: To evaluate the accuracy of thin-section computed tomography (CT) with expiratory scans in diagnosing early bronchiolitis obliterans after lung transplantation. MATERIALS AND METHODS: Thin-section CT scans were reviewed by two observers blinded to the diagnoses in seven consecutive lung transplant recipients with histopathologically proved bronchiolitis obliterans (group A) and 21 with normal biopsy findings (group B). All patients had normal biopsy and stable pulmonary function test (PFT) results 2-36 weeks prior to CT. Patients with normal biopsy results were placed into subgroups based on abnormal (group B1) or stable (group B2) PFT results. Air- trapping extent on expiratory scans was scored on a 24-point scale. RESULTS: The mean air-trapping score in group A (6.6) was not significantly different from that in group B (4.5, P = .17). The air-trapping score was significantly higher in groups A and B1 than in group B2 (6.2 and 2.6, respectively; P = .03). The frequency of an air-trapping score of 3 or more in groups A and B1 was significantly higher than that in group B2 (P = .03). By using a score of 3 or more to indicate air trapping, the sensitivity of expiratory CT was 74%, specificity was 67%, and accuracy was 71%. CONCLUSION: Thin-section CT, including expiratory scans, is of limited accuracy in diagnosing early bronchiolitis obliterans after lung transplantation.

AB - PURPOSE: To evaluate the accuracy of thin-section computed tomography (CT) with expiratory scans in diagnosing early bronchiolitis obliterans after lung transplantation. MATERIALS AND METHODS: Thin-section CT scans were reviewed by two observers blinded to the diagnoses in seven consecutive lung transplant recipients with histopathologically proved bronchiolitis obliterans (group A) and 21 with normal biopsy findings (group B). All patients had normal biopsy and stable pulmonary function test (PFT) results 2-36 weeks prior to CT. Patients with normal biopsy results were placed into subgroups based on abnormal (group B1) or stable (group B2) PFT results. Air- trapping extent on expiratory scans was scored on a 24-point scale. RESULTS: The mean air-trapping score in group A (6.6) was not significantly different from that in group B (4.5, P = .17). The air-trapping score was significantly higher in groups A and B1 than in group B2 (6.2 and 2.6, respectively; P = .03). The frequency of an air-trapping score of 3 or more in groups A and B1 was significantly higher than that in group B2 (P = .03). By using a score of 3 or more to indicate air trapping, the sensitivity of expiratory CT was 74%, specificity was 67%, and accuracy was 71%. CONCLUSION: Thin-section CT, including expiratory scans, is of limited accuracy in diagnosing early bronchiolitis obliterans after lung transplantation.

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