Birgitta Versluijs

High-resolution CT can differentiate between alloimmune and non-alloimmune lung disease early after hematopoietic cell transplantation A.B. Versluys, M.B. Bierings, F.J. Beek, J.J. Boelens, C.K. van der Ent, P.A. de Jong American Journal of Roentgenology (AJR) 2014; 203: 656–661 Abstract Objective  The purpose of this study was to develop a sim- ple semiquantitative high-resolution CT (HRCT) scoring system to differentiate alloimmune-mediated lung syndro- mes (allo-LS) from other lung diseases early after hemato- poietic cell transplantation. Allo-LS should be differentiated from other abnormalities, such as infections and toxicity, because they are life-threatening and require prompt and specific treatment. Materials and methods  In 52 pediatric hematopoietic cell transplant recipientswith early symptoms of pulmonary disease, a clinical diagnosis was made by an expert physi- cian. HRCT studies were scored by two independent radio- logists for various airway and parenchyma abnormalities. HRCT scores were compared with the final clinical diagno- ses. Results  Patients with allo-LS had significantly higher HR- CT severity scores for ground-glass pattern and airtrapping compared with patients with non-alloimmune disease. A combined score was constructed (the “allo-score”) that appeared to have good predictive capacity for clinical allo- LS (AUC = 0.82). HRCT scoring was reproducible for all items except airway wall thickening and septal thickening. Conclusion  A simple HRCT severity score can be helpful to differentiate allo-LS from other pulmonary complications early after hematopoietic cell transplantation. Blood and Marrow Transplantation Program, Department of Pediatrics, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands A.B. Versluys M.B. Bierings J.J. Boelens Department of Pediatric Radiology, UMCU, Wilhel- mina Children's Hospital, Utrecht, The Netherlands F.J. Beek P.A. de Jong Department of Paediatric Pulmonology, UMCU, Wilhelmina Children’s Hospital, Utrecht, The Netherlands C.K. van der Ent