title: Predictive equations for lung volumes from computed tomography for size matching in pulmonary transplantation.
abstract: OBJECTIVE
  Size matching for lung transplantation is widely accomplished using height comparisons between donors and recipients. This gross approximation allows for wide variation in lung size and, potentially, size mismatch. Three-dimensional computed tomography (3D-CT) volumetry comparisons could offer more accurate size matching. Although recipient CT scans are universally available, donor CT scans are rarely performed. Therefore, predicted donor lung volumes could be used for comparison to measured recipient lung volumes, but no such predictive equations exist. We aimed to use 3D-CT volumetry measurements from a normal patient population to generate equations for predicted total lung volume (pTLV), predicted right lung volume (pRLV), and predicted left lung volume (pLLV), for size-matching purposes.
  
  
  METHODS
  Chest CT scans of 400 normal patients were retrospectively evaluated. 3D-CT volumetry was performed to measure total lung volume, right lung volume, and left lung volume of each patient, and predictive equations were generated. The fitted model was tested in a separate group of 100 patients. The model was externally validated by comparison of total lung volume with total lung capacity from pulmonary function tests in a subset of those patients.
  
  
  RESULTS
  Age, gender, height, and race were independent predictors of lung volume. In the test group, there were strong linear correlations between predicted and actual lung volumes measured by 3D-CT volumetry for pTLV (r = 0.72), pRLV (r = 0.72), and pLLV (r = 0.69). A strong linear correlation was also observed when comparing pTLV and total lung capacity (r = 0.82).
  
  
  CONCLUSIONS
  We successfully created a predictive model for pTLV, pRLV, and pLLV. These may serve as reference standards and predict donor lung volume for size matching in lung transplantation.
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Md.
authors.forename: Jeremy A
authors.initials: JA
authors.lastname: Konheim
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Md.
authors.forename: Zachary N
authors.initials: ZN
authors.lastname: Kon
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Md. Electronic address: cpasrija@smail.umaryland.edu.
authors.forename: Chetan
authors.initials: C
authors.lastname: Pasrija
authors.affiliation: Division of Applied Health Services Research, Ochsner Clinic Foundation, New Orleans, La.
authors.forename: Qingyang
authors.initials: Q
authors.lastname: Luo
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Md.
authors.forename: Pablo G
authors.initials: PG
authors.lastname: Sanchez
authors.affiliation: Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Mass.
authors.forename: Jose P
authors.initials: JP
authors.lastname: Garcia
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Md.
authors.forename: Bartley P
authors.initials: BP
authors.lastname: Griffith
authors.affiliation: Division of Thoracic Radiology, University of Maryland School of Medicine, Baltimore, Md.
authors.forename: Jean
authors.initials: J
authors.lastname: Jeudy
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001827:Body Height; D046148:Donor Selection; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D016014:Linear Models; D008168:Lung / Q000000981:diagnostic imaging* / Q000502:physiology; D016040:Lung Transplantation / Q000379:methods*; D008176:Lung Volume Measurements / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D061330:Multidetector Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D044469:Racial Groups; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult
keywords: computed tomography; lung; lung transplantation; organ donor management; regression analysis