Pre-Hematopoietic Stem Cell Transplantation Lung Computed Tomography as an Alternative to the Pulmonary Function Test during the COVID-19 Pandemic

Masaharu Tamaki, Hideki Nakasone, Tadao Aikawa, Yuhei Nakamura, Masakatsu Kawamura, Shunto Kawamura, Junko Takeshita, Nozomu Yoshino, Yukiko Misaki, Kazuki Yoshimura, Shinpei Matsumi, Ayumi Gomyo, Aki Tanihara, Machiko Kusuda, Yu Akahoshi, Shun ichi Kimura, Shinichi Kako, Noriko Oyama-Manabe, Yoshinobu Kanda

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

The pulmonary function test (PFT) is an important test for risk stratification before allogeneic transplantation (allo-HCT). However, it might be preferable to avoid PFT as much as possible in the recent era of coronavirus disease 2019 (COVID-19), because PFT requires forced expirations and might produce aerosols, increasing the risk of COVID-19 transmission. Therefore, we tried to predict normal PFT results before allo-HCT based on computed tomography (CT) findings. This study included 390 allo-HCT recipients at our center for whom lung CT images and PFT results before allo-HCT were available. Abnormal CT findings were less likely to be observed in the normal PFT group (47.0% versus 67.4%, P = .015), with a high negative predictive value of 92.9%. In a multivariate analysis, normal CT was significantly associated with normal PFT (odds ratio, 2.47; 95% confidence interval, 1.22 to 4.97; P = .012). A model for predicting normal PFT was constructed based on the results of a multivariate analysis, and the area under the curve of the receiver operating characteristic analysis was 0.656, which gave a sensitivity of 45.5% and a specificity of 86.0%. The relatively high specificity of the model suggested that PFT can be omitted in patients with normal CT findings before allo-HCT.

Original languageEnglish
Pages (from-to)2318-2322
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume26
Issue number12
DOIs
StatePublished - Dec 2020
Externally publishedYes

Keywords

  • COVID-19
  • Computed tomography
  • Pulmonary function test

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