Does high-resolution CT has diagnostic value in patients presenting with respiratory symptoms after hematopoietic stem cell transplantation?

Abstract Background Hematopoietic stem cell transplantation (SCT) can be complicated by a variety of live-threatening infectious and non-infectious pulmonary complications. The management of these complications is critically dependent on the most probable diagnosis, which is in part based on imaging...

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Bibliographic Details
Published in:European journal of radiology 2011-12, Vol.80 (3), p.e536-e543
Main Authors: Wijers, Sofieke C, Boelens, Jaap Jan, Raphael, Martine. F, Beek, Frederik J, de Jong, Pim A
Format: Article
Language:English
Subjects:
Diagnosis
Hematopoietic stem cell transplantation
Hematopoietic Stem Cell Transplantation - adverse effects
High-resolution computed tomography
Humans
Imaging
Radiographic Image Enhancement - methods
Radiology
Reproducibility of Results
Respiration Disorders - diagnostic imaging
Respiration Disorders - etiology
Respiratory complication
Sensitivity and Specificity
Tomography, X-Ray Computed - methods
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Summary:Abstract Background Hematopoietic stem cell transplantation (SCT) can be complicated by a variety of live-threatening infectious and non-infectious pulmonary complications. The management of these complications is critically dependent on the most probable diagnosis, which is in part based on imaging work-up. Methods Systematic review of the literature related to the diagnostic value of high-resolution computed tomography (HRCT) in patients who underwent SCT and developed respiratory symptoms. Results Literature review did not reveal systematic cohort studies that included patients with respiratory symptoms post-SCT who underwent HRCT and had a well-defined outcome. Most studies selected participants based on their final diagnosis instead of the indication for diagnostic testing in practice. Nevertheless, several papers clearly indicated a potential role for HRCT when complications after SCT occur. A variety of articles described the role of certain HRCT findings in the diagnosis of specific infectious complications, but less data were available for non-infectious complications. Conclusion We believe more diagnostic studies are needed to determine the value of HRCT for a specific diagnosis in SCT-recipients who present with respiratory symptoms at the transplant clinic. Currently, radiologists should be cautious since HRCT interpretation in these patients is not unambiguous.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2011.01.037