Related Experiment Video
Updated: Apr 4, 2026
Unilateral Lung Volume Analysis Using Micro-CT for Enhanced Assessment of Pulmonary Fibrosis in Preclinical Models
Published on: June 20, 2025
Low-dose computed tomography volumetry for subtyping chronic lung allograft dysfunction.
Tomohito Saito1, Miho Horie2, Masaaki Sato3
1Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute and Division of Thoracic Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada; Department of Thoracic and Cardiovascular Surgery, Kansai Medical University, Hirakara, Japan.
Low-dose 3D CT lung volumetry can differentiate restrictive allograft syndrome (RAS) from bronchiolitis obliterans syndrome (BOS) in lung transplant recipients. This imaging technique offers a valuable tool for diagnosing chronic lung allograft dysfunction (CLAD) subtypes.
Area of Science:
- Pulmonary Medicine
- Transplant Surgery
- Radiology
Background:
- Chronic lung allograft dysfunction (CLAD) is a major challenge in lung transplantation, with subtypes including bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS).
- Current diagnostic criteria for CLAD subtypes often rely on total lung capacity (TLC), which is not consistently measured post-transplant.
- Investigating alternative diagnostic methods is crucial for timely and accurate CLAD subtyping.
Purpose of the Study:
- To evaluate the effectiveness of low-dose 3D computed tomography (CT) lung volumetry in distinguishing between RAS and BOS.
- To determine if CT lung volumetry can serve as a reliable diagnostic tool for CLAD subtypes.
Main Methods:
- Retrospective analysis of 63 patients with CLAD post-lung or heart-lung transplantation (44 BOS, 19 RAS).
- CT lung volumes were measured as a percentage of baseline, analyzing chronologic changes at disease onset.
- Diagnostic accuracy of CT lung volume for differentiating RAS from BOS was assessed using receiver operating characteristic (ROC) curve analysis.
Main Results:
- RAS demonstrated a significant decrease in CT lung volume at disease onset compared to baseline (p < 0.0001).
- BOS showed no significant change in CT lung volume post-transplant (p = 0.214).
- CT lung volume achieved high diagnostic accuracy (0.938) in differentiating RAS from BOS, with an area under the ROC curve of 0.959 (p < 0.0001).
Conclusions:
- Low-dose CT lung volumetry is a valuable tool for differentiating RAS from BOS in lung transplant recipients with CLAD.
- This imaging technique can aid in the accurate diagnosis of CLAD subtypes when TLC measurements are unavailable.
- CT volumetry provides objective data to support clinical assessment in post-transplant care.
