Journal article
CT strain metrics allow for earlier diagnosis of bronchiolitis obliterans syndrome after hematopoietic cell transplant
Blood advances, Vol.8(19), pp.5156-5165
10/08/2024
DOI: 10.1182/bloodadvances.2024013748
PMCID: PMC11470239
PMID: 39163616
Abstract
-Quantitative CT lung strain can diagnose early BOS before decline in percent predicted forced expiratory volume in 1 second (FEV1%).-Quantitative CT lung strain can distinguish types of BOS.
Bronchiolitis obliterans syndrome (BOS) after hematopoietic cell transplantation (HCT) is associated with substantial morbidity and mortality. Quantitative CT (qCT) can help diagnose advanced BOS meeting National Institutes of Health (NIH) criteria (NIH-BOS) but has not been used to diagnose early, often asymptomatic BOS (early BOS), limiting the potential for early intervention and improved outcomes. Using Pulmonary Function Tests (PFT) to define NIH-BOS, early BOS, and mixed BOS (NIH-BOS with restrictive lung disease) in patients from two large cancer centers, we applied qCT to identify early BOS and distinguish between types of BOS. Patients with transient impairment or healthy lungs were included for comparison. PFT were done at month 0, 6, and 12. Analysis was performed with association statistics, principal component analysis, conditional inference trees (CIT), and machine learning (ML) classifier models. Our cohort included 84 allogeneic HCT recipients -- 66 BOS (NIH-defined, early, or mixed) and 18 without BOS. All qCT metrics had moderate correlation with Forced Expiratory Volume in 1 second, and each qCT metric differentiated BOS from those without BOS (non-BOS) (P < 0.0001). CIT’s distinguished 94% of participants with BOS versus non-BOS, 85% early BOS versus non-BOS, 92% early BOS versus NIH-BOS. ML models diagnosed BOS with area under the curve (AUC) 0.84 (95% confidence interval [CI] 0.74-0.94) and early BOS with AUC 0.84 (95% CI 0.69 – 0.97). Quantitative CT metrics can identify individuals with early BOS, paving the way for closer monitoring and earlier treatment in this vulnerable population.
Details
- Title: Subtitle
- CT strain metrics allow for earlier diagnosis of bronchiolitis obliterans syndrome after hematopoietic cell transplant
- Creators
- Husham Sharifi - Stanford UniversityChristopher D. Bertini - The University of Texas Health Science Center at HoustonMansour Alkhunaizi - Stanford UniversityMaria Hernandez - The University of Texas Health Science Center at HoustonZayan Musa - Stanford University School of MedicineCarlos Borges - Stanford University School of MedicineIhsan Turk - Stanford UniversityLara Bashoura - The University of Texas MD Anderson Cancer CenterBurton F. Dickey - The University of Texas MD Anderson Cancer CenterGuang-Shing Cheng - Fred Hutch Cancer CenterGregory Yanik - University of MichiganCraig J. Galban - University of MichiganHuawei Henry Guo - Stanford UniversityMyrna C.B. Godoy - The University of Texas MD Anderson Cancer CenterJoseph M. Reinhardt - University of IowaEric A. Hoffman - University of IowaMario Castro - University of Kansas Medical CenterGabriela Rondon - The University of Texas MD Anderson Cancer CenterAmin M. Alousi - The University of Texas MD Anderson Cancer CenterRichard E. Champlin - The University of Texas MD Anderson Cancer CenterElizabeth J. Shpall - The University of Texas MD Anderson Cancer CenterYing Lu - Stanford UniversitySamuel Peterson - Vida Diagnostics (United States)Keshav Datta - Stanford UniversityMark R. Nicolls - Palo Alto UniversityJoe Hsu - Palo Alto UniversityAjay Sheshadri - The University of Texas MD Anderson Cancer Center
- Resource Type
- Journal article
- Publication Details
- Blood advances, Vol.8(19), pp.5156-5165
- DOI
- 10.1182/bloodadvances.2024013748
- PMID
- 39163616
- PMCID
- PMC11470239
- NLM abbreviation
- Blood Adv
- ISSN
- 2473-9529
- eISSN
- 2473-9537
- Publisher
- Elsevier Inc
- Grant note
- National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI): R01HL161037 NIH/National Cancer Institute (NCI): P30 CA015704 NIH/NHLBI: R01HL162661, R01HL157414-01 NIH/National Institute of Allergy and Infectious Diseases grant: K23 AI117024
The authors acknowledge the patients in the lung GVHD clinics of Stanford University Medical Center and MD Anderson Cancer Center.During this study period, G.-S.C. was funded by National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI) grant R01HL161037 and NIH/National Cancer Institute (NCI) grant P30 CA015704. G.Y. and C.J.G. are funded by NIH/NHLBI grant R01HL162661. J.H. was funded through NIH/NHLBI grant R01HL157414-01. A.S. is funded by NIH/National Institute of Allergy and Infectious Diseases grant K23 AI117024.
- Language
- English
- Electronic publication date
- 08/20/2024
- Date published
- 10/08/2024
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984699248302771
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