TY - JOUR
T1 - Multidimensional volumetric imaging of pulmonary infiltrates for measuring therapeutic response to antifungal therapy in experimental invasive pulmonary aspergillosis
AU - Petraitis, Vidmantas
AU - Petraitiene, Ruta
AU - Solomon, Jeffrey
AU - Kelaher, Amy M.
AU - Murray, Heidi A.
AU - Mya-San, Christine
AU - Bhandary, Avi K.
AU - Sein, Tin
AU - Avila, Nilo A.
AU - Basevicius, Algidas
AU - Bacher, John
AU - Walsh, Thomas J.
PY - 2006/4
Y1 - 2006/4
N2 - Pulmonary infiltrates in neutropenic hosts with invasive pulmonary aspergillosis are caused by vascular invasion, hemorrhagic infarction, and tissue necrosis. Monitoring the dynamics of pulmonary infiltrates of invasive aspergillosis is an important tool tor assessing response to antifungal therapy. We, therefore, introduced a multidimensional volumetric imaging (MDVI) method tor analysis of the response of the volume of pulmonary infiltrates over time to antifungal therapy in experimental invasive pulmonary aspergillosis (IPA) in persistently neutropenic rabbits. We developed a semiautomatic method to measure the volume of lung lesions, which was implemented as an extension of the MEDx visualization and analysis software using ultrafast computerized tomography (UFCT). Volumetric infiltrate measures were compared with UFCT reading, histopathological resolution of lesions, microbiological clearance of Aspergillus fumigatus, and galactomannan index (GMI). We also studied the MDVI method for consistency and reproducibility in comparison to UFCT. Treatment groups consisted of deoxycholate amphotericin B (DAMB) at 0.5 or 1 mg/kg of body weight/day and untreated controls (UC). Therapeutic monitoring of pulmonary infiltrates using MDVI demonstrated a significant decrease in the infiltrate volume in DAMB-treated rabbits in comparison to UC (P ≤ 0.001). Volumetric data by MDVI correlated with conventional CT pulmonary scores (r = 0.83, P ≤ 0.001). These results correlated with validated biological endpoints: pulmonary infarct scores (r = 0.85, P ≤ 0.001), lung weights (r = 0.76, P ≤ 0.01), residual fungal burden (r = 0.65, P ≤ 0.05), and GMI (r = 0.78, P ≤ 0.01). MDVI correlated with key biological markers, improved the objectivity of radiological assessment of therapeutic response to antifungal therapy, and warrants evaluation for monitoring therapeutic response in immunocompromised patients with invasive aspergillosis.
AB - Pulmonary infiltrates in neutropenic hosts with invasive pulmonary aspergillosis are caused by vascular invasion, hemorrhagic infarction, and tissue necrosis. Monitoring the dynamics of pulmonary infiltrates of invasive aspergillosis is an important tool tor assessing response to antifungal therapy. We, therefore, introduced a multidimensional volumetric imaging (MDVI) method tor analysis of the response of the volume of pulmonary infiltrates over time to antifungal therapy in experimental invasive pulmonary aspergillosis (IPA) in persistently neutropenic rabbits. We developed a semiautomatic method to measure the volume of lung lesions, which was implemented as an extension of the MEDx visualization and analysis software using ultrafast computerized tomography (UFCT). Volumetric infiltrate measures were compared with UFCT reading, histopathological resolution of lesions, microbiological clearance of Aspergillus fumigatus, and galactomannan index (GMI). We also studied the MDVI method for consistency and reproducibility in comparison to UFCT. Treatment groups consisted of deoxycholate amphotericin B (DAMB) at 0.5 or 1 mg/kg of body weight/day and untreated controls (UC). Therapeutic monitoring of pulmonary infiltrates using MDVI demonstrated a significant decrease in the infiltrate volume in DAMB-treated rabbits in comparison to UC (P ≤ 0.001). Volumetric data by MDVI correlated with conventional CT pulmonary scores (r = 0.83, P ≤ 0.001). These results correlated with validated biological endpoints: pulmonary infarct scores (r = 0.85, P ≤ 0.001), lung weights (r = 0.76, P ≤ 0.01), residual fungal burden (r = 0.65, P ≤ 0.05), and GMI (r = 0.78, P ≤ 0.01). MDVI correlated with key biological markers, improved the objectivity of radiological assessment of therapeutic response to antifungal therapy, and warrants evaluation for monitoring therapeutic response in immunocompromised patients with invasive aspergillosis.
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UR - http://www.scopus.com/inward/citedby.url?scp=33645781541&partnerID=8YFLogxK
U2 - 10.1128/AAC.50.4.1510-1517.2006
DO - 10.1128/AAC.50.4.1510-1517.2006
M3 - Article
C2 - 16569871
AN - SCOPUS:33645781541
SN - 0066-4804
VL - 50
SP - 1510
EP - 1517
JO - Antimicrobial agents and chemotherapy
JF - Antimicrobial agents and chemotherapy
IS - 4
ER -