SESSION TYPE: Lung Transplantation Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: Post transplant shortness of breath is a difficult entity to evaluate. Its differentials are broad and objective tools to assist the physician can be limited. Invasive procedures often have to be performed to understand the disease process in question. This study aims to define the relationship between densitometric changes within a patients CT scan and their lungs function.
METHODS: All patients having undergone a medically indicated outpatient spirometry and non-contrast CT-scan of the chest done within a two week period were included in this analysis. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and if available total lung capcity (TLC) and diffusing capcity of carbon monoxide (DLCO) were collected from the pulmonary function test (PFT) laboratory. The CT image was analyzed for mean lung density, areas of the lung with low relative density (below the mean) and high density (above the mean). It was also analyzed for areas of low variance and high variance. Each areas variance was determined by calculating variance in attenuation in a 5mm by 5mm square for each 1mm square block of lung tissue. If a patient had a repeat CT and spirometry done, this data was also included to determine if a change in spirometry correlated with a change in CT-densitometric values.
RESULTS: 12 patients meeting the inclusion criteria were enrolled with 4 of them having serial studies for analysis. Only four patients had TLC and DLCO available for analysis. No significant correlation was found between FEV1 or FVC and any densitometric variable. A strong negative correlation was found between DLCO and mean lung density (r=-0.997, n=4, p=0.003). A negative correlation between change in FVC and change in mean lung density was seen (r=-0.90, p=0.10); however, it did not reach statistical significance.
CONCLUSIONS: This small analysis of post transplant patients suggests that there may be a role for quantitative analysis of CT scans in post transplant patients. Data from more patients will need to be analyzed before this can be integrated into a patient care plan.
CLINICAL IMPLICATIONS: Lung functions in patients who are unable to properly perform a PFT to standard are difficult to follow. Determining the full utility of quantified CT in select populations may offer an opportunity for an alternate objective method to quantidy lung function
DISCLOSURE: The following authors have nothing to disclose: Irtza Sharif, Nadeem Ali, Dave Siegel, Christina Migliore, Sean Studer
Images are exported from the PACS server and loaded into research software for analysis. There is no commercial product or FDA approval for the use of any of the information it provides. No intervention is done on patients for investigative purpose and CT images are taken from patients retrospectively from patients who had the scan for clinical indications. Information obtained has not been made available to the clinicians taking care of the patients and has not been put in the medical recordNewark Beth Israel Medical Center, Newark, NJ