Quantitative assessment of lung damage due to bleomycin using computed tomography

Visual assessment and density measurements of the lung using computed tomography (CT) were made in 18 patients undergoing treatment with bleomycin for malignant teratoma of the testis. The results of both visual assessment and density measurements were compared with changes in gas transfer per unit lung volume (KCO). Visual assessment of severity of damage to the lungs caused by bleomycin is unrelated to changes in KCO but is characteristic of bleomycin damage and allows a confident diagnosis to be made. Quantitative density measurement by CT, however, is inversely related to changes in KCO and may therefore be used to monitor the physiological effect on the patient. Examination of the lung by CT in these patients can not only characterise and define the extent of lung damage due to bleomycin but can be used to give a quantitative measurement on which to monitor treatment.