Differences of airway dimensions between patients with and without bronchiolitis obliterans syndrome after lung transplantation-Computer-assisted quantification of computed tomography

BACKGROUND: The aim of our retrospective study was to determine whether a dedicated software for assessment of airway morphology can detect differences in airway dimensions between patients with and without bronchiolitis obliterans syndrome (BOS), regarded as the clinical correlate of chronic lung allograft rejection. METHODS: 12 patients with and 14 patients without diagnosis of BOS were enrolled in the study. Evaluation of bronchial wall area percentage (WA%) and bronchial wall thickness (WT) in all follow-up CT scans was performed using a semiautomatic airway assessment tool. We assessed temporal changes (DeltaWA%, DeltaWT) and compared these morphological parameters with forced expiratory volume in one second (DeltaFEV1). RESULTS: In patients with and without BOS, the temporal changes over the entire follow-up were 26.6% versus 16.2% for DeltaFEV1 (p=0.034), 14.2% versus 5.4% for DeltaWA% (p=0.003) and 0.212mm versus 0.064mm for DeltaWT (p=0.011). CONCLUSIONS: We detected significant differences of the temporal changes of airway dimensions (DeltaWA%, DeltaWT) between lung transplant recipients with and without BOS. We conclude that computer-assisted bronchial wall measurements in CT scans might complement the information from pulmonary function tests and establish as a non-invasive method to confirm BOS in lung transplant recipients in the future.

• Doellinger, F.
• Weinheimer, O.
• Zwiener, I.
• Mayer, E.
• Buhl, R.
• Fahlenkamp, U. L.
• Dueber, C.
• Achenbach, T.