THE ASSOCIATION OF VOXEL-LEVEL LUNG DEFORMATION INDICES WITH AIRFLOW OBSTRUCTION IN POST-HEMATOPOIETIC CELL TRANSPLANTATION BRONCHIOLITIS OBLITERANS SYNDROME

TOPIC: Imaging TYPE: Original Investigations PURPOSE: Bronchiolitis obliterans syndrome (BOS) is the most common form of lung chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation, often presenting as severe airflow obstruction. Prior studies have shown associations between quantitative CT (qCT) air trapping (AT) and airway morphometry (AM) measurements FEV1 impairment. We developed qCT methods to measure voxel-level changes in magnitude direction deformation from inspiration expiration (I/E). hypothesized that would better capture extent pulmonary impairment BOS compared classic AT or AM indices. METHODS: prospectively enrolled 27 patients at MD Anderson with (n=14), mild not meeting NIH criteria for (BOS 0p, n=10), cGVHD who had no (n=3). performed baseline I/E function tests. measured using probability mapping (DPM, VIDA Diagnostics, Iowa City, IA). calculated volume change each voxel reported whole means (JacMean), standard deviations (SD) within-lung Jacobian (JacSD). isotropy anisotropic index (ADI, ranges 0-1 0 implying total isotropy), mean whole-lung ADI (ADImean) SD (ADISD). Pearson’s correlations markers predicted (FEV1%), group differences controls, BOS0p later (n=4) vs. those did (n=5). RESULTS: ADImean correlated best FEV1% (r=0.76, 95% confidence interval [CI] 0.53-0.88), followed by ADISD (r=0.68, CI 0.41-0.84), JacMean (r=0.67, 0.38-0.84), JacSD 0.39-0.84). DPM more weakly (r= -0.60, -0.80 -0.28), while correlate FEV1%. Patients decreased (1.90 2.75, p=0.004) (0.51 1.15, p=0.002), indicating a lower degree inspiration, less heterogeneity deformation. isotropic (ADImean 0.46 0.92, p<0.0001) variation within (ADISD 0.36 0.59, p=0.01). (27% 7%), but this meet statistical significance (p=0.11), partly due variability among few controls. No if 0p subsequently progressed BOS. CONCLUSIONS: Voxel-level tightly should be further explored biomarkers. CLINICAL IMPLICATIONS: may powerful way BOS, opposed traditional approaches estimate proportion trapped remodeling measurable large airways. DISCLOSURES: disclosure on file Amin Alousi; relevant relationships Muhammad Hasan Arain, source=Web Response Lara Bashoura, Christopher Bertini, Author relationship Elsevier Please note: $1-$1000 Mario Castro, Response, value=Royalty Removed 04/30/2021 Principal Investigator Novartis $20001 - $100000 value=Grant/Research Support Consultant $5001 $20000 value=Consulting fee AstraZeneca Speaker/Speaker's Bureau value=Honoraria ALA Sanofi-Aventis Regeneron Advisory Committee Member PCORI Added Teva GSK Genentech Shionogi >$100000 Ongoing value=Study Funding Richard Champlin, Burton Dickey, Myrna Godoy; Maria Hernandez, Eric Hoffman; Chitra Hosing, Kristofer Jennings, kind effort Siemens Healthineers Oct 2017 present Rick Layman, GE Healthcare 2019-present value=Travel Stephen McEleney; Rohtesh Mehta, Diana Montanez, Laila Noor, source=Admin input grant Intuitive Surgical David Ost, Sophie Paczesny, Uday Popat, Gabriela Rondon, Psioxus Therapeutics 3/1/20-7/1/20 Ajay Sheshadri, Enanta Pharmaceuticals 01/01/21-ongoing Vida Diagnostics Inc 2015 05/03/2021 Jered Sieren,