Feasibility of thoracic CT in assessing anemia for aplastic anemia patients undergoing allogeneic hematopoietic stem cell transplantation

Article type: Research Article

Authors: Chen, Dandan^{a; b; 1} | Guo, Yuan^{b; 1} | Liu, Weifeng^{c; 1} | Yuan, Zhaohu^d | Mo, Wenjian^{e; *} | Wei, Xinhua^{a; b; *}

Affiliations: [a] First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China | [b] Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China | [c] Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China | [d] Department of Blood Transfusion, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China | [e] Department of Hematology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China

Correspondence: [*] Corresponding authors. Xinhua Wei and Wenjian Mo, Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Yuexiu District, Guangzhou, Guangdong 510180, China. Tel./Fax: +86 020 81048873; E-mails: eyxinhuawei@163.com (XW) and eywjmo@scut.edu.cn (WM).

Note: [1] Dandan Chen, Yuan Guo and Weifeng Liu contributed equally to this work.

Abstract: BACKGROUND:Anemia is an important clinical symptom for aplastic anemia (AA) patients who are suffered with peripheral pancytopenia. OBJECTIVE:To evaluate the accuracy of diagnosing anemia with non-invasive chest computed tomography (CT) for AA patients. METHODS:The CT attenuation of left ventricular (LV) cavity and interventricular septum (IVS) on unenhanced thoracic CT images of AA patients are retrospectively analyzed, including 84 AA patients in pre-transplant and 1-month (n = 82), 2-month (n = 72), 3-month (n = 75), 6-month (n = 74) and 12-month (n = 70) followed patients in post-transplant. The difference (IVS-LV) and ratio (LV/IVS) of the CT attenuation between LV cavity and interventricular septum are calculated. Serum hemoglobin is estimated within 24 hours of CT imaging. The CT attenuations of IVS-LV and LV/IVS are correlated with hemoglobin, and their variation tendency is analyzed during the treatment of a-HSCT. A receiver operating characteristic (ROC) curve analysis is then performed for the diagnosis of anemia. RESULTS:The CT attenuations of IVS-LV and LV/IVS well correlate with hemoglobin (r = –0.618 and 0.628, respectively, P <  0.001). The variation tendency of IVS-LV and LV/IVS is similar to that of hemoglobin with opposite directions during one-year follow-up of a-HSCT. When a threshold of CT attenuation of IVS-LV and LV/IVS is set at 11.5HU and 0.77, respectively, both the sensitivity and specificity in diagnosing anemia are good (74.7% and 73.8% in CT attenuation of IVS-LV; 77.4% and 70.4% in LV/LVS, respectively). CONCLUSIONS:Both CT attenuation of LV/IVS and IVS-LV had similar accuracy in diagnosing anemia for AA patients. The non-invasive chest CT can offer a new possibility to complementarily evaluate anemia for AA patients in the diagnostic radiology reports.

Keywords: Anemia, computed tomography, allogeneic hematopoietic stem cell transplantation, hemoglobin, aplastic anemia

DOI: 10.3233/XST-221296

Journal: Journal of X-Ray Science and Technology, vol. 31, no. 1, pp. 199-209, 2023