title: The role of multidetector computed tomography in the early diagnosis of invasive pulmonary aspergillosis in patients with febrile neutropenia undergoing hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  To evaluate vessel involvement and the role of multidetector computed tomography (MDCT) in the earlydiagnosis of invasive pulmonary aspergillosis (IPA) in patients with febrile neutropenia and antibiotic-resistant feverundergoing autologous bone morrow transplantation.
  
  
  METHODS
  In all, 74 pulmonary MDCT examinations in 37 consecutive hematopoietic stem celltransplantation patients with febrile neutropenia and clinically suspected IPA were retrospectively evaluated.
  
  
  RESULTS
  Diagnosis of IPA was based on Fungal Infections Cooperative Group, and National Institute of Allergy andInfectious Diseases Mycoses Study Consensus Group criteria. In all, 0, 14, and 11 patients were diagnosed as proven,probable, and possible IPA, respectively. Among the 25 patients accepted as probable and possible IPA, all had pulmonaryMDCT findings consistent with IPA. The remaining 12 patients were accepted as having fever of unknown origin (FUO)and had patent vessels based on MDCT findings.In the patients with probable and possible IPA, 72 focal pulmonary lesions were observed; in 41 of the 72 (57%) lesionsvascular occlusion was noted and the CT halo sign was observed in 25 of these 41 (61%) lesions. Resolution of feveroccurred following antifungal therapy in 19 (76%) of the 25 patients with probable and possible IPA. In all, 6 (25%)of the patients diagnosed as IPA died during follow-up. Transplant-related mortality 100 d post transplant in patientswith IPA and FUO was 24% and 0%, respectively.
  
  
  CONCLUSIONS
  In conclusion, MDCT has a potential role in the early diagnosis of IPA via detection of vessel occlusion.
authors.affiliation: Ankara Oncology Education and Research Hospital, Department of Radiology, Ankara, Turkey.
authors.forename: Nazan
authors.initials: N
authors.lastname: Ciledağ
authors.affiliation: Ankara Oncology Education and Research Hospital, Department of Radiology, Ankara, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Arda
authors.affiliation: Ankara Oncology Education and Research Hospital, Department of Radiology, Ankara, Turkey.
authors.forename: Bilgin Kadri
authors.initials: BK
authors.lastname: Arıbaş
authors.affiliation: Ankara Oncology Education and Research Hospital, Department of Hematology and BMT Unit, Ankara, Turkey.
authors.forename: Ali Irfan Emre
authors.initials: AI
authors.lastname: Tekgündüz
authors.affiliation: Ankara Oncology Education and Research Hospital, Department of Hematology and BMT Unit, Ankara, Turkey.
authors.forename: Fevzi
authors.initials: F
authors.lastname: Altuntaş
keywords: Febrile neutropenia; Hematopoietic stem cell transplantation; Invasive pulmonary aspergillosis; Multidetector computed tomography
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