Bronchial Wall Measurements in Patients after Lung Transplantation: Evaluation of the Diagnostic Value for the Diagnosis of Bronchiolitis Obliterans Syndrome

Abstract

ObjectivesTo prospectively evaluate quantitative airway wall measurements of thin-section CT for the diagnosis of Bronchiolitis Obliterans Syndrome (BOS) following lung transplantation.Materials and MethodsIn 141 CT examinations, bronchial wall thickness (WT), the wall area percentage (WA%) calculated as the ratio of the bronchial wall area and the total area (sum of bronchial wall area and bronchial lumen area) and the difference of the WT on inspiration and expiration (WTdiff) were automatically measured in different bronchial generations. The measurements were correlated with the lung function parameters. WT and WA% in CT examinations of patients with (n = 25) and without (n = 116) BOS, were compared using the unpaired t-test and univariate analysis of variance, while also considering the differing lung volumes.ResultsMeasurements could be performed in 2,978 bronchial generations. WT, WA%, and WTdiff did not correlate with the lung function parameters (r<0.5). The WA% on inspiration was significantly greater in patients with BOS than in patients without BOS, even when considering the dependency of the lung volume on the measurements. WT on inspiration and expiration and WA% on expiration did not show significant differences between the groups.ConclusionWA% on inspiration was significantly greater in patients with than in those without BOS. However, WA% measurements were significantly dependent on lung volume and showed a high variability, thus not allowing the sole use of bronchial wall measurements to differentiate patients with from those without BOS.

Effects of paclitaxel intervention on pulmonary vascular remodeling in rats with pulmonary hypertension

“…The mean pulmonary artery pressure (mPAP) and the right ventricular hypertrophy index [ratio of right ventricle (RV) to left ventricle + septum (LV+S)] were detected as previously described (22). Right lung tissues (7×7 mm 2 ) were subjected to hematoxylin (0.5%; 5–10 min) and eosin (1.0%; 3–5 min) staining at room temperature, immunohistochemistry and elastic Van Gieson staining (0.22% Verhoeff solution; room temperature; 15–60 min), and the percentage wall thickness (WT) was measured as previously described (23). In addition, the neointimal proliferation degree of the pulmonary artery was determined as described previously (24).…”

Chronic Lung Allograft Dysfunction Post Lung Transplantation: A Review of Computed Tomography Quantitative Methods for Detection and Follow-Up

“…Dettmer [ 9 ] evaluated 25 patients with BOS and 116 controls using MeVis Airway Examiner. WA% on inspiration was significantly greater in patients with BOS, but the variability of bronchial wall measurements was high and the values for the WA% on inspiration in patients with and without BOS overlapped considerably, due to variable underlying lung volumes.…”

“…CT: computer tomography, CLAD: chronic lung allograft dysfunction. Airway measurement methods [ 8 , 9 , 12 , 14 ], Vascular measurement methods [ 14 ], Parenchyma based methods [ 10 , 11 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

“…Quantitative imaging has been mainly used for the evaluation of BOS, the obstructive phenotype of CLAD. The implementation of such imaging analysis tools for CLAD evaluation in LTx patients either directly confirms airway thickening and vascular remodeling in the allograft lung [ 8 , 9 ] or indirectly suggests their occurrence through air-trapping quantification [ 10 , 11 ]. Applying machine learning to imaging data analysis may further improve the management of CLAD [ 12 ].…”

Quantification of Pathologic Air Trapping in Lung Transplant Patients Using CT Density Mapping: Comparison with Other CT Air Trapping Measures

“…Volumetric non-enhanced CT examinations were performed for all subjects at total lung capacity (TLC) and at functional residual capacity (FRC) after standardized breath-hold instructions using a spirometer as previously described [ 17 ]. All scans were performed on a 64 multi detector row CT scanner (Lightspeed VCT, GE Healthcare, Milwaukee, WI, USA) with parameters for both scans as follows: collimation 1.25 mm, a reconstruction interval of 1 mm using “standard” reconstruction kernel, with 100 kVp, automatic tube current modulation (Smart mA GE), a rotation time of 0.8 s and a pitch of 0.984.…”