Chest CT: parenchymal patterns and density in CLAD
Evidence level: abstract-only studies (two cohorts) and a preprint; no imaging consensus text opened
Chest CT appears in the 2019 phenotype table for restrictive disease and in studies of CT density and early opacities.
As of . Primary source: Horie et al. 2018 (DOI).
Summary
An open-access review, as tabulated on the RAS record, lists parenchymal opacities or pleural thickening on CT as part of the restrictive phenotype. A Toronto study (Horie 2018) reports that, according to its abstract, RAS shows increased overall CT lung density and BOS reduced density, and that a reader-independent density metric calculated from CT histograms at CLAD onset in 74 patients was associated with survival. A KU Leuven nested case-control study (Beeckmans 2025) reports persistent chest CT opacities in the absence of pulmonary dysfunction as an early indicator of later RAS. The Ishiwata preprint on this site describes a group of explanted CLAD lungs with a restrictive-pattern chest imaging finding (RLO) versus those without. A registry-listed imaging study using xenon MRI is described on a separate record. The sources are abstracts or secondary descriptions; no imaging thresholds are given here.
Sources and links
Related
Links from this record
- supports: Quantitative chest CT for subtyping chronic lung allograft dysfunction and its association with survival.
- supports: Clinical predictors for restrictive allograft syndrome: A nested case-control study.
- describes RLO group: Distinct fibrotic, epithelial and immune transcriptomic programs in phenotypes of chronic lung allograft dysfunction
- describes new opacities: Phenotyping of chronic lung allograft dysfunction in the ScanCLAD study
- RAS consensus (not opened): Chronic lung allograft dysfunction: Definition and update of restrictive allograft syndrome: A consensus report from the Pulmonary Council of the ISHLT
- used to define: Restrictive allograft syndrome (RAS)
- contrasted: Bronchiolitis obliterans syndrome (BOS)
Linked from (derived)
- supports: Phenotyping CLAD after single lung transplant: Limits and prognostic assessment of the 2019 ISHLT classification system
- reports use of: Chronic lung allograft dysfunction after lung transplantation: prevention, diagnosis and treatment in 44 European centres
- supports: Chronic lung allograft dysfunction and restrictive allograft syndrome: are phenotypes robust and helpful?
- discusses: Global approaches to chronic lung allograft dysfunction: Toward evidence-based harmonization
- affects: Clinical CLAD phenotypes are hard to assign reproducibly
- affects: CLAD care and measurement vary between centres
Known gaps in this record
- CT definition of restrictive disease in the 2019 consensus text (not opened)
- sensitivity and specificity of CT findings (not in the abstracts read)
- full text of all sources
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.