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Related Experiment Video

Updated: Oct 17, 2025

Unilateral Lung Volume Analysis Using Micro-CT for Enhanced Assessment of Pulmonary Fibrosis in Preclinical Models
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Chronic lung allograft dysfunction subtype analysis by computed tomography volumetry.

Laura H Peräkylä1, Peter M Raivio1, Risto I Kesävuori2

  • 1Department of Cardiac Surgery, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Clinical Transplantation
|October 11, 2021
PubMed
Summary
This summary is machine-generated.

Computed tomography (CT) volumetry can identify subtypes of chronic lung allograft dysfunction (CLAD). Restrictive allograft syndrome (RAS) identified by CT volumetry indicates a worse prognosis and decreased graft survival post-lung transplant.

Keywords:
chronic lung allograft dysfunctioncomputed tomography volumetrylung transplantation

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Area of Science:

  • Pulmonary Medicine
  • Transplantation Surgery
  • Radiology

Background:

  • Chronic lung allograft dysfunction (CLAD) is a major limitation to long-term survival following lung transplantation.
  • Restrictive allograft syndrome (RAS) is a subtype of CLAD with poorer prognosis than bronchiolitis obliterans syndrome (BOS).
  • Computed tomography (CT) volumetry offers a method to differentiate CLAD subtypes and assess clinical impact.

Purpose of the Study:

  • To utilize CT volumetry for classifying CLAD subtypes in lung transplant recipients.
  • To determine the clinical impact and prognostic value of CT-volumetry-defined CLAD subtypes.

Main Methods:

  • Retrospective evaluation of 167 adult primary lung transplants (2003-2015).
  • CLAD classification using CT volumetry: <15% lung volume decrease for BOSCT-vol, ≥15% for RASCT-vol.
  • Comparison of lung function, radiological parameters, and graft survival between CLAD subtypes.

Main Results:

  • CLAD affected 43% of patients; 89% were BOSCT-vol, 11% were RASCT-vol.
  • Median graft survival was significantly lower in RASCT-vol (1.6 years) versus BOSCT-vol (9.7 years).
  • RASCT-vol diagnosis, increased lung density, and greater FEV1 decline independently predicted increased graft loss risk.

Conclusions:

  • CT volumetry is effective in identifying lung transplant patients with poor clinical outcomes.
  • RASCT-vol, identified by significant lung volume decrease, is associated with worse prognosis.
  • Prospective validation of CT volumetry for CLAD subtyping is recommended.