Diagnostic Performance of Contrast Enhanced Pulmonary Computed Tomography Angiography for the Detection of Angioinvasive Pulmonary Aspergillosis in Immunocompromised Patients

Abstract Invasive pulmonary aspergillosis (IPA) is one of the major complications in immunocompromised patients. The mainstay of diagnostic imaging is non-enhanced chest-computed-tomography (CT), for which various non-specific signs for IPA have been described. However, contrast-enhanced CT pulmonar...

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Autores principales:	C. Henzler, T. Henzler, D. Buchheidt, John W. Nance, C. A. Weis, R. Vogelmann, U. Benck, T. Viergutz, T. Becher, T. Boch, S. A. Klein, D. Heidenreich, L. Pilz, M. Meyer, P. M. Deckert, W.-K. Hofmann, S. O. Schoenberg, M. Reinwald
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/07a7934a19f94141a338e22488859379
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spelling	oai:doaj.org-article:07a7934a19f94141a338e224888593792021-12-02T16:08:19ZDiagnostic Performance of Contrast Enhanced Pulmonary Computed Tomography Angiography for the Detection of Angioinvasive Pulmonary Aspergillosis in Immunocompromised Patients10.1038/s41598-017-04470-62045-2322https://doaj.org/article/07a7934a19f94141a338e224888593792017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-04470-6https://doaj.org/toc/2045-2322Abstract Invasive pulmonary aspergillosis (IPA) is one of the major complications in immunocompromised patients. The mainstay of diagnostic imaging is non-enhanced chest-computed-tomography (CT), for which various non-specific signs for IPA have been described. However, contrast-enhanced CT pulmonary angiography (CTPA) has shown promising results, as the vessel occlusion sign (VOS) seems to be more sensitive and specific for IPA in hematologic patients. The aim of this study was to evaluate the diagnostic accuracy of CTPA in a larger cohort including non-hematologic immunocompromised patients. CTPA studies of 78 consecutive immunocompromised patients with proven/probable IPA were analyzed. 45 immunocompromised patients without IPA served as a control group. Diagnostic performance of CTPA-detected VOS and of radiological signs that do not require contrast-media were analyzed. Of 12 evaluable radiological signs, five were found to be significantly associated with IPA. The VOS showed the highest diagnostic performance with a sensitivity of 0.94, specificity of 0.71 and a diagnostic odds-ratio of 36.8. Regression analysis revealed the two strongest independent radiological predictors for IPA to be the VOS and the halo sign. The VOS is highly suggestive for IPA in immunocompromised patients in general. Thus, contrast-enhanced CTPA superior over non-contrast_enhanced chest-CT in patients with suspected IPA.C. HenzlerT. HenzlerD. BuchheidtJohn W. NanceC. A. WeisR. VogelmannU. BenckT. ViergutzT. BecherT. BochS. A. KleinD. HeidenreichL. PilzM. MeyerP. M. DeckertW.-K. HofmannS. O. SchoenbergM. ReinwaldNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q C. Henzler T. Henzler D. Buchheidt John W. Nance C. A. Weis R. Vogelmann U. Benck T. Viergutz T. Becher T. Boch S. A. Klein D. Heidenreich L. Pilz M. Meyer P. M. Deckert W.-K. Hofmann S. O. Schoenberg M. Reinwald Diagnostic Performance of Contrast Enhanced Pulmonary Computed Tomography Angiography for the Detection of Angioinvasive Pulmonary Aspergillosis in Immunocompromised Patients
description	Abstract Invasive pulmonary aspergillosis (IPA) is one of the major complications in immunocompromised patients. The mainstay of diagnostic imaging is non-enhanced chest-computed-tomography (CT), for which various non-specific signs for IPA have been described. However, contrast-enhanced CT pulmonary angiography (CTPA) has shown promising results, as the vessel occlusion sign (VOS) seems to be more sensitive and specific for IPA in hematologic patients. The aim of this study was to evaluate the diagnostic accuracy of CTPA in a larger cohort including non-hematologic immunocompromised patients. CTPA studies of 78 consecutive immunocompromised patients with proven/probable IPA were analyzed. 45 immunocompromised patients without IPA served as a control group. Diagnostic performance of CTPA-detected VOS and of radiological signs that do not require contrast-media were analyzed. Of 12 evaluable radiological signs, five were found to be significantly associated with IPA. The VOS showed the highest diagnostic performance with a sensitivity of 0.94, specificity of 0.71 and a diagnostic odds-ratio of 36.8. Regression analysis revealed the two strongest independent radiological predictors for IPA to be the VOS and the halo sign. The VOS is highly suggestive for IPA in immunocompromised patients in general. Thus, contrast-enhanced CTPA superior over non-contrast_enhanced chest-CT in patients with suspected IPA.
format	article
author	C. Henzler T. Henzler D. Buchheidt John W. Nance C. A. Weis R. Vogelmann U. Benck T. Viergutz T. Becher T. Boch S. A. Klein D. Heidenreich L. Pilz M. Meyer P. M. Deckert W.-K. Hofmann S. O. Schoenberg M. Reinwald
author_facet	C. Henzler T. Henzler D. Buchheidt John W. Nance C. A. Weis R. Vogelmann U. Benck T. Viergutz T. Becher T. Boch S. A. Klein D. Heidenreich L. Pilz M. Meyer P. M. Deckert W.-K. Hofmann S. O. Schoenberg M. Reinwald
author_sort	C. Henzler
title	Diagnostic Performance of Contrast Enhanced Pulmonary Computed Tomography Angiography for the Detection of Angioinvasive Pulmonary Aspergillosis in Immunocompromised Patients
title_short	Diagnostic Performance of Contrast Enhanced Pulmonary Computed Tomography Angiography for the Detection of Angioinvasive Pulmonary Aspergillosis in Immunocompromised Patients
title_full	Diagnostic Performance of Contrast Enhanced Pulmonary Computed Tomography Angiography for the Detection of Angioinvasive Pulmonary Aspergillosis in Immunocompromised Patients
title_fullStr	Diagnostic Performance of Contrast Enhanced Pulmonary Computed Tomography Angiography for the Detection of Angioinvasive Pulmonary Aspergillosis in Immunocompromised Patients
title_full_unstemmed	Diagnostic Performance of Contrast Enhanced Pulmonary Computed Tomography Angiography for the Detection of Angioinvasive Pulmonary Aspergillosis in Immunocompromised Patients
title_sort	diagnostic performance of contrast enhanced pulmonary computed tomography angiography for the detection of angioinvasive pulmonary aspergillosis in immunocompromised patients
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/07a7934a19f94141a338e22488859379
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Diagnostic Performance of Contrast Enhanced Pulmonary Computed Tomography Angiography for the Detection of Angioinvasive Pulmonary Aspergillosis in Immunocompromised Patients

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