Diagnostic imaging of experimental invasive pulmonary aspergillosis

Area of Science:

• Medical Imaging
• Mycology
• Pharmacology

Background:

• Invasive aspergillosis in neutropenic hosts causes pulmonary infiltrates via tissue injury and vascular invasion.
• Accurate radiological assessment is crucial for evaluating antifungal therapy effectiveness.

Purpose of the Study:

• To evaluate ultrafast computed tomography (UFCT) scanning for measuring pulmonary lesions in experimental invasive aspergillosis.
• To introduce and validate multidimensional volumetric imaging (MDVI) for assessing antifungal treatment response.
• To correlate imaging findings with established clinical and microbiological endpoints.

Main Methods:

• Experimental invasive pulmonary aspergillosis was established in persistently neutropenic rabbits.
• Lesions were quantified using UFCT scanning and a pulmonary lesion score.
• A novel MDVI method was developed to analyze pulmonary infiltrate volume over time.
• UFCT and MDVI data were correlated with survival, histopathology, and galactomannan index.

Main Results:

• UFCT scanning reproducibly measured pulmonary lesions in experimental aspergillosis.
• The UFCT pulmonary lesion score correlated well with survival, histopathology, and microbiological clearance.
• MDVI volumetric data showed strong correlation with UFCT scores and validated biological endpoints.
• A pilot clinical study indicated MDVI's applicability to human pulmonary fungal infections.

Conclusions:

• UFCT scanning is a valuable tool for assessing invasive pulmonary aspergillosis and antifungal efficacy in preclinical models.
• MDVI offers an objective, volumetric approach to evaluating therapeutic response in pulmonary fungal infections.
• MDVI warrants further investigation in clinical settings for invasive aspergillosis and other pneumonias.