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Quantitative computed tomography assessment of graft-versus-host disease-related bronchiolitis obliterans in children: A pilot feasibility study

 Hyun Gi Kim  ;  Hyun Joo Shin  ;  Yoon Hee Kim  ;  Myung Hyun Sohn  ;  Chuhl Joo Lyu  ;  Myung-Joon Kim  ;  Kyung Won Kim  ;  Mi-Jung Lee 
 EUROPEAN RADIOLOGY, Vol.25(10) : 2931-2936, 2015 
Journal Title
Issue Date
Adolescent ; Air ; Bronchiolitis Obliterans/diagnostic imaging* ; Child ; Feasibility Studies ; Female ; Forced Expiratory Volume ; Graft vs Host Disease/diagnostic imaging* ; Humans ; Lung/diagnostic imaging ; Male ; Pilot Projects ; Respiratory Function Tests ; Retrospective Studies ; Tomography, X-Ray Computed/methods
Lung ; Quantitative computed tomography ; Pulmonary emphysema ; Airway obstruction ; Graft-versus-host disease
OBJECTIVE: To suggest a simple method that can quantify air trapping from chest CT in children with graft-versus-host disease (GVHD)-related bronchiolitis obliterans (BO). METHODS: This institutional review board-approved retrospective study included eight GVHD-related BO patients (age, 6 - 17 years) who underwent both 31 CTs of variable settings and pulmonary function tests (PFT). The attenuation values of lung parenchyma in normal (An) and air trapping (Aa) areas were obtained. Individualized threshold [(An + Aa)/2] and fixed threshold of -950 HU were set for air trapping quantification. Spearman correlation analysis and generalized linear mixed models were used for statistical analysis. RESULTS: The mean value of individualized threshold was -830.2 ± 48.3 HU. The mean air trapping lung volume percentage with individualized threshold and -950 HU were 45.4 ± 18.9% and 1.4 ± 1.9%, respectively. The air trapping lung volume percentage with individualized threshold showed a significant negative correlation with the PFT of FEV1/FVC% in all data (γ = -0.795, P < .001) and in the correction of repetition (γ = -0.837, P = .010). CONCLUSIONS: We suggest a simple and individualized threshold attenuation setting method for air trapping quantification insusceptible to CT imaging protocols or respiratory phase control in children with GVHD-related BO. KEY POINTS: • Simple and individualized threshold attenuation setting for air trapping quantification is possible. • Individualized threshold attenuation setting is insusceptible to CT imaging protocols or respiratory phase control. • CT air trapping quantification correlates with PFT of pulmonary obstruction.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Myung Joon(김명준) ORCID logo https://orcid.org/0000-0002-4608-0275
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Kim, Hyun Gi(김현지)
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
Shin, Hyun Joo(신현주) ORCID logo https://orcid.org/0000-0002-7462-2609
Lyu, Chuhl Joo(유철주) ORCID logo https://orcid.org/0000-0001-7124-7818
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
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