Cystic fibrosis: Usefulness of thoracic CT in the examination of patients before lung transplantation

PURPOSE: To evaluate the usefulness of thoracic computed tomography (CT) in the pre-lung transplantation examination of patients with cystic fibrosis (CF). MATERIALS AND METHODS: Fifty-six patients (age range, 12-42 years) with CF were evaluated for possible lung transplantation from 1991 to 1997 Twenty-s ix of these patients underwent bilateral lung transplantation, 19 were awai ting transplantation at the time of the study, seven died before transplant ation, and four were excluded for psychosocial concerns. Preoperative chest radiographic and CT findings were reviewed and correlated;with clinical, o perative, and pathology records. RESULTS: in seven patients, discrete, 1-2-cm pulmonary nodules were detecte d at CT. Five of these patients underwent transplantation; the nodules Were found to be mucous impactions. No malignancy was found: in any of the pati ents who underwent transplantation. Pretransplantation sputum cultures grew Aspergillus fumigatus in seven patients, none of whom had radiologic findi ngs suggestive of Aspergillus infection. Radiographic or CT findings were s uggestive of mycetoma in five cases, but no such tumors were found at trans plantation. The accuracies of chest radiography and CT for the detection of pleural disease in 48 hemithoraces. were 81% (n = 39) and 69% (n = 33), re spectively. The radiologic findings-of pleural thickening did not influence the surgical approach in any patient. CONCLUSION: Thoracic CT has little utility in the routine pre-lung transpla ntation examination of patients with CF.