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Diagnostic value of ventilation/perfusion single-photon emission computed tomography/computed tomography for bronchiolitis obliterans syndrome in patients after lung transplantation

Nakashima, Masahiroa; Shinya, Takayoshib; Oto, Takahiroc; Okawa, Tomoyoc; Takeda, Yoshihiroa

Nuclear Medicine Communications: July 2019 - Volume 40 - Issue 7 - p 703–710
doi: 10.1097/MNM.0000000000001021
ORIGINAL ARTICLES
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Objective To evaluate the diagnostic value of function volume/morphological volume ratio calculated from ventilation/perfusion single-photon emission computed tomography/computed tomography in distinguishing the lungs with bronchiolitis obliterans syndrome (BOS) from the lungs without this syndrome after lung transplantation and to assess its relationship with spirometry parameters.

Materials and methods We retrospectively identified 84 consecutive lung transplant recipients and 13 donors who underwent ventilation/perfusion single-photon emission computed tomography/computed tomography. Differences in the function volume/morphological volume ratio of unilateral lungs were tested for significance between the lungs with and without BOS. Receiver operating characteristics and correlations between function volume/morphological volume ratios of bilateral lungs and forced expiratory volume in 1 s, forced vital capacity, and total lung capacity were analyzed.

Results The function volume/morphological volume ratios of ventilation and perfusion images of unilateral lungs were significantly lower in lungs with BOS (each P<0.0001). The area under the curve values of ventilation and perfusion images were 0.97 and 0.99, respectively. Significant correlations were identified between the function volume/morphological volume ratios of ventilation and perfusion images and forced expiratory volume in 1 s (r=0.54, P<0.0001 and r=0.45, P<0.0001, respectively). The function volume/morphological volume ratio of ventilation image had a significantly weak correlation with forced vital capacity.

Conclusion The function volume/morphological volume ratio enables a semiquantitative assessment of ventilation and perfusion lung functions and is useful for diagnosing BOS after lung transplantation.

aDepartment of Radiological Technology, Graduate School of Health Sciences, Okayama University

bDepartment of Pediatric Radiology

cDepartment of Organ Transplant Center, Okayama University Hospital, Okayama, Japan

Correspondence to Masahiro Nakashima, MS, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan Tel: +86 235 7782; fax: +86 235 7781; e-mail: nakas-m@cc.okayama-u.ac.jp

Received October 26, 2018

Accepted April 8, 2019

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