Universität zu Köln

Vehreschild, J. J., Heussel, C. P., Groll, A. H., Vehreschild, M. J. G. T., Silling, G., Wuerthwein, G., Brecht, M. and Cornely, O. A. (2017). Serial assessment of pulmonary lesion volume by computed tomography allows survival prediction in invasive pulmonary aspergillosis. Eur. Radiol., 27 (8). S. 3275 - 3283. NEW YORK: SPRINGER. ISSN 1432-1084

Full text not available from this repository.

Abstract

Serial chest CT is the standard of care to establish treatment success in invasive pulmonary aspergillosis (IPA). Data are lacking how response should be defined. Digital CT images from a clinical trial on treatment of IPA were re-evaluated and compared with available biomarkers. Total volume of pneumonia was added up after manual measurement of each lesion, followed by statistical analysis. One-hundred and ninety CT scans and 309 follow-up datasets from 40 patients were available for analysis. Thirty-one were neutropenic. Baseline galactomannan (OR 4.06, 95%CI: 1.08-15.31) and lesion volume (OR 3.14, 95%CI: 0.73-13.52) were predictive of death. Lesion volume at d7 and trend between d7 and d14 were strong predictors of death (OR 20.01, 95%CI: 1.42-282.00 and OR 15.97, 95%CI: 1.62-157.32) and treatment being rated as unsuccessful (OR 4.75, 95%CI: 0.94-24.05 and OR 40.69, 95%CI: 2.55-649.03), which was confirmed by a Cox proportional hazards model using time-dependent covariates. Any increase in CT lesion volume between day 7 and day 14 was a sensitive marker of a lethal outcome (> 50%), supporting a CT rescan each one and 2 weeks after initial detection of IPA. The predictive value exceeded all other biomarkers. Further CT follow-up after response at day 14 was of low additional value. aEuro cent CT evaluation offers good prediction of outcome for invasive pulmonary aspergillosis. aEuro cent Predictive capability exceeds galactomannan, blood counts, and lesion count. aEuro cent Any progression between day 7 and day 14 constitutes a high-risk scenario.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Vehreschild, J. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heussel, C. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Groll, A. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, M. J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Silling, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wuerthwein, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brecht, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, O. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-224048
DOI:	10.1007/s00330-016-4717-4
Journal or Publication Title:	Eur. Radiol.
Volume:	27
Number:	8
Page Range:	S. 3275 - 3283
Date:	2017
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1084
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FEBRILE NEUTROPENIC PATIENTS; CELL TRANSPLANT RECIPIENTS; II DOSE-ESCALATION; FUNGAL-INFECTIONS; PHASE-II; IMMUNOCOMPROMISED PATIENTS; AMPHOTERICIN-B; FOLLOW-UP; CASPOFUNGIN; DISEASE Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22404