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Togni Filho PH, Casagrande JLM, Lederman HM. Utility of the inspiratory phase in high-resolution computed tomography evaluations of pediatric patients with bronchiolitis obliterans after allogeneic bone marrow transplant: reducing patient radiation exposure. Radiol Bras. 2017;50(2):90-96doi: 10.1590/0100-3984.2015.0181.
Togni Filho, P. H., Casagrande, J. L. M., & Lederman, H. M. (2017). Utility of the inspiratory phase in high-resolution computed tomography evaluations of pediatric patients with bronchiolitis obliterans after allogeneic bone marrow transplant: reducing patient radiation exposure. Radiologia brasileira, 50(2), 90-96. https://doi.org/10.1590/0100-3984.2015.0181
Togni Filho, Paulo Henrique, et al. "Utility of the inspiratory phase in high-resolution computed tomography evaluations of pediatric patients with bronchiolitis obliterans after allogeneic bone marrow transplant: reducing patient radiation exposure." Radiologia brasileira vol. 50,2 (2017): 90-96. doi: https://doi.org/10.1590/0100-3984.2015.0181
Togni Filho PH, Casagrande JLM, Lederman HM. Utility of the inspiratory phase in high-resolution computed tomography evaluations of pediatric patients with bronchiolitis obliterans after allogeneic bone marrow transplant: reducing patient radiation exposure. Radiol Bras. 2017 Mar-Apr;50(2):90-96. doi: 10.1590/0100-3984.2015.0181. PMID: 28428651; PMCID: PMC5396998.
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Radiol Bras. 2017 Mar-Apr;50(2):90-96. doi: 10.1590/0100-3984.2015.0181.

Utility of the inspiratory phase in high-resolution computed tomography evaluations of pediatric patients with bronchiolitis obliterans after allogeneic bone marrow transplant: reducing patient radiation exposure.

Radiologia brasileira

Paulo Henrique Togni Filho, João Luiz Marin Casagrande, Henrique Manoel Lederman

Affiliations

  1. MD, MSc, Attending Physician, Department of Diagnostic Imaging, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
  2. Radiologist, Fellow in Musculoskeletal Imaging, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil.
  3. Tenured Full Professor, Department of Diagnostic Imaging, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.

PMID: 28428651 PMCID: PMC5396998 DOI: 10.1590/0100-3984.2015.0181

Abstract

OBJECTIVE: To evaluate the utility of the inspiratory phase in high-resolution computed tomography (HRCT) of the chest for the diagnosis of post-bone marrow transplantation bronchiolitis obliterans.

MATERIALS AND METHODS: This was a retrospective, observational, cross-sectional study. We selected patients of either gender who underwent bone marrow transplantation and chest HRCT between March 1, 2002 and December 12, 2014. Ages ranged from 3 months to 20.7 years. We included all examinations in which the HRCT was performed appropriately. The examinations were read by two radiologists, one with extensive experience in pediatric radiology and another in the third year of residency, who determined the presence or absence of the following imaging features: air trapping, bronchiectasis, alveolar opacities, nodules, and atelectasis.

RESULTS: A total of 222 examinations were evaluated (mean, 5.4 ± 4.5 examinations per patient). The expiratory phase findings were comparable to those obtained in the inspiratory phase, except in one patient, in whom a small uncharacteristic nodule was identified only in the inspiratory phase. Air trapping was identified in a larger number of scans in the expiratory phase than in the inspiratory phase, as was atelectasis, although the difference was statistically significant only for air trapping.

CONCLUSION: In children being evaluated for post-bone marrow transplantation bronchiolitis obliterans, the inspiratory phase can be excluded from the chest HRCT protocol, thus reducing by half the radiation exposure in this population.

Keywords: Bone marrow transplantation; Bronchiolitis obliterans; Radiation dosage; Tomography, X-ray computed

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