title: Bronchiolitis obliterans syndrome in lung transplant recipients: use of spirometrically gated CT.
abstract: OBJECTIVE
  To assess the potential use of spirometrically gated lung computed tomographic (CT) findings in the diagnosis of bronchiolitis obliterans syndrome after lung transplantation.
  
  
  METHODS
  Forty-nine lung transplant recipients were examined at least 8 months after surgery with spirometrically gated thin-section CT of the lung. In addition to visual signs of small-airway disease at CT, mean lung attenuation and the SD were numerically determined and compared with the results of lung function testing at the time of the CT examination and 1 year later by using factorial analysis of variance.
  
  
  RESULTS
  Mean lung attenuation was significantly lower in patients who developed bronchiolitis obliterans syndrome within 1 year after the CT study (-837 HU +/- 3) than in patients with persistent normal lung function (-812 HU +/- 3, P <.001). With an optimal threshold, sensitivity was 69%, specificity was 71%, and accuracy was 84%. Visual analysis did not significantly contribute to the prognostic power of CT.
  
  
  CONCLUSIONS
  Spirometrically gated CT measurements of lung attenuation can be used to predict the onset of bronchiolitis obliterans syndrome after lung transplantation.
authors.affiliation: Department of Radiology, Charité, Campus Virchow-Klinikum, Humboldt-University, Augustenburger Platz 1, 13353 Berlin, Germany. friedrich.knollmann @charite.de
authors.forename: Friedrich D
authors.initials: FD
authors.lastname: Knollmann
authors.forename: Ralf
authors.initials: R
authors.lastname: Ewert
authors.forename: Tarja
authors.initials: T
authors.lastname: Wündrich
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Roland
authors.initials: R
authors.lastname: Felix
mesh_terms: D000328:Adult; D001989:Bronchiolitis Obliterans / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016040:Lung Transplantation / Q000000981:diagnostic imaging; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D013147:Spirometry; D013577:Syndrome; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*