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

Eur J Radiol. 2011 Dec;80(3):e536-43. doi: 10.1016/j.ejrad.2011.01.037. Epub 2011 Feb 2.

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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Radiographic Image Enhancement / methods*
  • Reproducibility of Results
  • Respiration Disorders / diagnostic imaging*
  • Respiration Disorders / etiology*
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*