High Resolution Multislice Computed Tomography in the early phase after Stem Cell Transplantation

Abstract

Purpose: To evaluate the role of high resolution multislice computed tomography (HRCT) in the detection and monitoring of pulmonary infections after stem cell transplantation. Materials and Methods: Over a 5-year period, 113 patients (52f/61m, mean age 46 years, range, 19-77) with fever of unknown origin after stem cell transplantation underwent examination by a multi-detector row HRCT for evaluation of possible pneumonia in a prospective study. A baseline HRCT was performed in 19/113 of these patients before stem cell transplantation due to a high risk profile, and 61/113 patients underwent follow-up HRCT within 60 days after stem cell transplantation. The standard for comparing the diagnosis of pneumonia with the radiological findings in a total of 232 HRCT was based on combination of bronchoscopy, biochemistry and microbiological data. Results: HRCT detected pulmonary opacities in 73/113 patients after stem cell transplantation (19/73 fungal pneumonia, 17/73 bacterial pneumonia, 4/73 viral pneumonia, 33/73 non specific). The sensitivity, specificity and diagnostic accuracy of HRCT for pneumonia was 86%, 75% and 80% respectively. Diagnostic accuracy increased to 83% when follow-up HRCT was performed. Conclusion: HRCT was useful for detection and monitoring of pulmonary infections after stem cell transplantation.