Diagnostic imaging of experimental invasive pulmonary aspergillosis

Thomas Walsh, Vidmantas Petraitis, Ruta Petraitiene, Jeffrey Solomon, John Bacher, Lora Greene, Margaret Cotton, Andreas Groll, Emmanuel Roilides, Nilo Avila, Vasilios Pyrgos, Shmuel Shoham

Research output: Contribution to journalArticlepeer-review

Abstract

Pulmonary infiltrates in neutropenic hosts with invasive aspergillosis are caused by organism-mediated tissue injury, vascular invasion, and hemorrhagic infarction. Ultrafast computed tomography (UFCT) scanning reproducibly measures these lesions in experimental invasive pulmonary aspergillosis in persistently neutropenic rabbits. The pulmonary lesion score from UFCT scanning is a useful outcome variable for measuring differences in efficacy of antifungal compounds alone and in combination, as well as the virulence of different strains and species of Aspergillus. Several studies demonstrate that the course of pulmonary lesions treated with amphotericin B, lipid formulations of amphotericin B, triazoles, echinocandins, and combination therapy measured by serial UFCT scans correlate with those measured by survival, histopathological resolution of lesions, microbiological clearance of Aspergillus fumigatus, and resolution of galactomannan index. We further developed a multidimensional volumetric imaging (MDVI) method for analysis of the volume of pulmonary infiltrates over time in response to antifungal therapy. Volumetric data by MDVI correlate with UFCT pulmonary lesion scores and validated biological endpoints. A recent pilot clinical study demonstrated the applicability of MDVI to human pulmonary fungal infections. MDVI also improves objectivity of radiological assessment of therapeutic response to antifungal therapy and merits more extensive evaluation in patients with invasive aspergillosis, as well as other fungal and bacterial pneumonias.

Original languageEnglish (US)
Pages (from-to)S138-S145
JournalMedical mycology
Volume47
Issue numberSUPPL. 1
DOIs
StatePublished - 2009
Externally publishedYes

Keywords

  • Antifungal therapy
  • Computed tomographic scanning
  • Invasive pulmonary aspergillosis
  • Multidimensional volumetric imagin
  • Ultrafast CT scanning

ASJC Scopus subject areas

  • Infectious Diseases

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