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Imaging of the Lungs in Organ Donors and its Clinical Relevance : A Retrospective Analysis

Bozovic, Gracijela LU ; Adlercreutz, Catharina; Höglund, Peter LU ; Björkman-Burtscher, Isabella LU ; Reinstrup, Peter LU ; Ingemansson, Richard LU ; Schaefer-Prokop, Cornelia M; Siemund, Roger LU and Geijer, Mats LU (2017) In Journal of Thoracic Imaging 32(2). p.107-114
Abstract

PURPOSE:: The aim of the study was to retrospectively evaluate the diagnostic imaging that potential lung donors undergo, the reader variability of image interpretation and its relevance for donation, and the potential information gained from imaging studies not primarily intended for lung evaluation but partially including them. MATERIALS AND METHODS:: Bedside chest radiography and computed tomography (CT), completely or incompletely including the lungs, of 110 brain-dead potential organ donors in a single institution during 2007 to 2014 were reviewed from a donation perspective. Two chest radiologists in consensus analyzed catheters and cardiovascular, parenchymal, and pleural findings. Clinical reports and study review were compared... (More)

PURPOSE:: The aim of the study was to retrospectively evaluate the diagnostic imaging that potential lung donors undergo, the reader variability of image interpretation and its relevance for donation, and the potential information gained from imaging studies not primarily intended for lung evaluation but partially including them. MATERIALS AND METHODS:: Bedside chest radiography and computed tomography (CT), completely or incompletely including the lungs, of 110 brain-dead potential organ donors in a single institution during 2007 to 2014 were reviewed from a donation perspective. Two chest radiologists in consensus analyzed catheters and cardiovascular, parenchymal, and pleural findings. Clinical reports and study review were compared for substantial differences in findings that could have led to a treatment change, triggered additional examinations such as bronchoscopy, or were considered important for donation. RESULTS:: Among 136 bedside chest radiographs, no differences between clinical reports and study reviews were found in 37 (27%), minor differences were found in 28 (21%), and substantial differences were found in 71 (52%) examinations (P<0.0001). In 31 of 42 (74%) complete or incomplete CT examinations, 50 of 74 findings with relevance for lung donation were not primarily reported (P<0.0001). CONCLUSIONS:: The majority of donor patients undergo only chest radiography. A targeted imaging review of abnormalities affecting the decision to use donor lungs may be useful in the preoperative stage. With a targeted list, substantial changes were made from initial clinical interpretations. CT can provide valuable information on donor lung pathology, even if the lungs are only partially imaged.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Thoracic Imaging
volume
32
issue
2
pages
107 - 114
publisher
Lippincott Williams and Wilkins
external identifiers
  • scopus:85008311709
  • wos:000395535000005
ISSN
0883-5993
DOI
10.1097/RTI.0000000000000255
language
English
LU publication?
yes
id
fc79569b-1c94-4c2d-b8ca-f3576167828a
date added to LUP
2017-02-01 13:21:20
date last changed
2018-05-29 12:16:23
@article{fc79569b-1c94-4c2d-b8ca-f3576167828a,
  abstract     = {<p>PURPOSE:: The aim of the study was to retrospectively evaluate the diagnostic imaging that potential lung donors undergo, the reader variability of image interpretation and its relevance for donation, and the potential information gained from imaging studies not primarily intended for lung evaluation but partially including them. MATERIALS AND METHODS:: Bedside chest radiography and computed tomography (CT), completely or incompletely including the lungs, of 110 brain-dead potential organ donors in a single institution during 2007 to 2014 were reviewed from a donation perspective. Two chest radiologists in consensus analyzed catheters and cardiovascular, parenchymal, and pleural findings. Clinical reports and study review were compared for substantial differences in findings that could have led to a treatment change, triggered additional examinations such as bronchoscopy, or were considered important for donation. RESULTS:: Among 136 bedside chest radiographs, no differences between clinical reports and study reviews were found in 37 (27%), minor differences were found in 28 (21%), and substantial differences were found in 71 (52%) examinations (P&lt;0.0001). In 31 of 42 (74%) complete or incomplete CT examinations, 50 of 74 findings with relevance for lung donation were not primarily reported (P&lt;0.0001). CONCLUSIONS:: The majority of donor patients undergo only chest radiography. A targeted imaging review of abnormalities affecting the decision to use donor lungs may be useful in the preoperative stage. With a targeted list, substantial changes were made from initial clinical interpretations. CT can provide valuable information on donor lung pathology, even if the lungs are only partially imaged.</p>},
  author       = {Bozovic, Gracijela and Adlercreutz, Catharina and Höglund, Peter and Björkman-Burtscher, Isabella and Reinstrup, Peter and Ingemansson, Richard and Schaefer-Prokop, Cornelia M and Siemund, Roger and Geijer, Mats},
  issn         = {0883-5993},
  language     = {eng},
  month        = {01},
  number       = {2},
  pages        = {107--114},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Journal of Thoracic Imaging},
  title        = {Imaging of the Lungs in Organ Donors and its Clinical Relevance : A Retrospective Analysis},
  url          = {http://dx.doi.org/10.1097/RTI.0000000000000255},
  volume       = {32},
  year         = {2017},
}