Low-dose computed tomography volumetry for subtyping XXXX .

@entity1 @entity4154 @entity358
BACKGROUND: The long-term success of lung transplantation is challenged by the development of @entity358 ( @entity358 ) and its distinct subtypes of @entity4154 ( @entity4154 ) and restrictive allograft syndrome (RAS). However, the current diagnostic criteria for @entity358 subtypes rely on total lung capacity (TLC), which is not always measured during routine post-transplant assessment. Our aim was to investigate the utility of low-dose 3-dimensional computed tomography (CT) lung volumetry for differentiating RAS from @entity4154 . METHODS: This study was a retrospective evaluation of 63 @entity1 who had developed @entity358 after bilateral lung or heart   lung transplantation between 2006 and 2011, including 44 @entity4154 and 19 RAS cases. Median post-transplant follow-up was 65 months in @entity4154 and 27 months in RAS. The median interval between baseline and the disease-onset time-point for CT volumetry was 11 months in both @entity4154 and RAS. Chronologic changes and diagnostic accuracy of CT lung volume (measured as percent of baseline) were investigated. RESULTS: RAS showed a significant decrease in CT lung volume at disease onset compared with baseline (mean 3,916 ml vs 3,055 ml when excluding opacities, p < 0.0001), whereas @entity4154 showed no significant post-transplant change (mean 4,318 ml vs 4,396 ml, p = 0.214). The area under the receiver operating characteristic curve of CT lung volume for differentiating RAS from @entity4154 was 0.959 (95% confidence interval 0.912 to 1.01, p < 0.0001) and the calculated accuracy was 0.938 at a threshold of 85%. CONCLUSION: In bilateral lung or heart   lung transplant @entity1 with @entity358 , low-dose CT volumetry is a useful tool to differentiate @entity1 who develop RAS from those who develop @entity4154 .
