Parametric Response Mapping of Bronchiolitis Obliterans Syndrome Progression After Lung Transplantation. Issue 11 (29th July 2016)

• Record Type: Journal Article
• Authors: Verleden, S. E.; Vos, R.; Vandermeulen, E.; Ruttens, D.; Bellon, H.; Heigl, T.; Van Raemdonck, D. E.; Verleden, G. M.; Lama, V.; Ross, B. D.; Galbán, C. J.; Vanaudenaerde, B. M.
• Is Part Of: American journal of transplantation. Volume 16:Issue 11(2016:Nov.)
• Page Start: 3262
• Page End: 3269
• Publication Date: 2016-07-29
• Subjects: clinical research/practice -- lung transplantation/pulmonology -- bronchiolitis obliterans (BOS) -- diagnostic techniques and imaging: computed tomography; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.13945
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : 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 (Tpre, T0, and Tpost, 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 Tpre to T0 (p = 0.006) and a concurrent decrease in healthy parenchyma (p = 0.02) in the BOS group. This change in PRM continued to Tpost, 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. Abstract : The authors investigate the utility of parametric response mapping (voxel‐to‐voxel comparison of inspiratory and expiratory CT scans) in quantifying bronchiolitis obliterans syndrome diagnosis and progression.