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2015 ; 10
(10
): e0139102
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gab.com Text
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Quantification of Pathologic Air Trapping in Lung Transplant Patients Using CT
Density Mapping: Comparison with Other CT Air Trapping Measures
#MMPMID26430890
Solyanik O
; Hollmann P
; Dettmer S
; Kaireit T
; Schaefer-Prokop C
; Wacker F
; Vogel-Claussen J
; Shin HO
PLoS One
2015[]; 10
(10
): e0139102
PMID26430890
show ga
To determine whether density mapping (DM) is more accurate for detection and
quantification of pathologic air trapping (pAT) in patients after lung
transplantation compared to other CT air trapping measures. One-hundred
forty-seven lung and heart-lung transplant recipients underwent CT-examinations
at functional residual capacity (FRC) and total lung capacity (TLC) and PFT six
months after lung transplantation. Quantification of air trapping was performed
with the threshold-based method in expiration (EXP), density mapping (DM) and the
expiratory to inspiratory ratio of the mean lung density (E/I-ratio MLD). A
non-rigid registration of inspiration-expiration CT-data with a following
voxel-to-voxel mapping was carried out for DM. Systematic variation of
attenuation ranges was performed for EXP and DM and correlated with the ratio of
residual volume to total lung capacity (RV/TLC) by Spearman rank correlation
test. AT was considered pathologic if RV/TLC was above the 95th percentile of the
predicted upper limit of normal values. Receiver operating characteristic (ROC)
analysis was performed. The optimal attenuation range for the EXP method was from
-790 HU to -950 HU (EXP(-790 to -950HU)) (r = 0.524, p<0.001) to detect air
trapping. Within the segmented lung parenchyma, AT was best defined as voxel
difference less than 80 HU between expiration and registered inspiration using
the DM method. DM correlated best with RV/TLC (r = 0.663, p<0.001). DM and
E/I-ratio MLD showed a larger AUC (0.78; 95% CI 0.69-0.86; 0.76, 95% CI
0.67-0.85) than EXP(-790 HU to -950 HU) (0.71, 95% CI 0.63-0.78). DM and
E/I-ratio MLD showed better correlation with RV/TLC and are more suited
quantitative CT-methods to detect pAT in lung transplant patients than the
EXP(-790HU to -950HU).