Serial Transthoracic Ultrasonography Studies in Hematopoietic Cell Transplant Patients: A Tool for Early Lung Pathology Detection

Meihua Zhu, Cynthia R. Gregory, Brandon Hayes-Lattin, Carol Jacoby, Xijun Zhang, Amber Halse, Fen Wang, Kenton W. Gregory, Richard T. Maziarz

Research output: Contribution to journalArticlepeer-review

Abstract

Early detection of pulmonary complications can improve outcomes for patients with hematological malignancy (HM). For detecting lung injuries, lung ultrasound (LUS) images have been found to be of greater sensitivity than radiographic images. Our group performed a pilot study of LUS imaging to enhance early detection of pulmonary complications in HM patients. This prospective single-center feasibility study evaluated LUS for detecting pulmonary complications in 18 HM patients enrolled while hospitalized for a hematopoietic cell transplant (HCT) (concurrent-HCT group) or re-hospitalized for complications (post-HCT group). Serial LUS exams were performed and assigned a score from 0 to 5 based on pleural line, B-line, consolidation and pleural effusion features. Correlations between patients’ clinical characteristics and LUS features were analyzed. Comparisons between the LUS and radiographic images were evaluated. In the concurrent-HCT patients (79 LUS exams), non-significant fluctuating findings were commonly identified, but one-third of the patients presented pathologic findings (LUS scores ≥ 3). In the post-HCT patients (29 LUS exams), LUS images revealed severe pathologic findings (LUS score = 5) in every patient and, compared with radiographic images, were more sensitive for detecting pleural effusions (p < 0.05). LUS can be routinely performed on hospitalized HM patients, allowing point-of-care early detection of pulmonary complications.

Original languageEnglish (US)
Pages (from-to)72-89
Number of pages18
JournalUltrasound in Medicine and Biology
Volume49
Issue number1
DOIs
StatePublished - Jan 2023
Externally publishedYes

Keywords

  • Hematologic malignancies
  • Hematopoietic cell transplant
  • Lung injury
  • Lung ultrasound
  • Pulmonary complications

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Biophysics
  • Acoustics and Ultrasonics

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