ArticleEuropean radiology2017
Serial assessment of pulmonary lesion volume by computed tomography allows survival prediction in invasive pulmonary aspergillosis.
Article in European radiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 41 citations in OpenAlex.
- Invasive aspergillosis in autoimmune inflammatory rheumatic diseases: epidemiology, risk factors, diagnosis, management and challenges.Annals of medicine · 2026Review
- Refractory versus resistant invasive aspergillosis.The Journal of antimicrobial chemotherapy · 2025Review
- Concordance of Chest Radiography and Chest Computed Tomography Findings in Patients with Hematologic Malignancy and Invasive Mucormycosis: What Are the Prognostic Implications?Journal of fungi (Basel, Switzerland) · 2024Article
- Sequential low-dose CT thorax scans to determine invasive pulmonary fungal infection incidence after allogeneic hematopoietic cell transplantation.Annals of hematology · 2023Observational
- Long-Term Kinetics of Serum Galactomannan during Treatment of Complicated Invasive Pulmonary Aspergillosis.Journal of fungi (Basel, Switzerland) · 2023Article
- Predictors of Early and Late Mortality for Patients with Hematologic Malignancy and Invasive Mold Disease.Journal of fungi (Basel, Switzerland) · 2021Article
- Invasive aspergillosis in solid organ transplant patients: diagnosis, prophylaxis, treatment, and assessment of response.BMC infectious diseases · 2021Article
- Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients.Medical mycology · 2021Article
- Real-world management of infection during chemotherapy for acute leukemia in Japan: from the results of a nationwide questionnaire-based survey by the Japan Adult Leukemia Study Group.International journal of hematology · 2020Article
- How Long Do We Need to Treat an Invasive Mold Disease in Hematology Patients? Factors Influencing Duration of Therapy and Future Questions.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Baseline Chest Computed Tomography as Standard of Care in High-Risk Hematology Patients.Journal of fungi (Basel, Switzerland) · 2020Article
- Invasive pulmonary aspergillosis in critically ill patients with hematological malignancies.Intensive care medicine · 2019Article
- Invasive mould infections in solid organ transplant patients: modifiers and indicators of disease and treatment response.Infection · 2019Review
- Review
- [Fungal infections].Der Internist · 2019Review
- Invasive Fungal Infection.Deutsches Arzteblatt international · 2019Review
- Galactomannan, a Surrogate Marker for Outcome in Invasive Aspergillosis: Finally Coming of Age.Frontiers in microbiology · 2018Review
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSerial chest CT is the standard of care to establish treatment success in invasive pulmonary aspergillosis (IPA). Data are lacking how response should be defined.
methodsDigital CT images from a clinical trial on treatment of IPA were re-evaluated and compared with available biomarkers. Total volume of pneumonia was added up after manual measurement of each lesion, followed by statistical analysis.
resultsOne-hundred and ninety CT scans and 309 follow-up datasets from 40 patients were available for analysis. Thirty-one were neutropenic. Baseline galactomannan (OR 4.06, 95%CI: 1.08-15.31) and lesion volume (OR 3.14, 95%CI: 0.73-13.52) were predictive of death. Lesion volume at d7 and trend between d7 and d14 were strong predictors of death (OR 20.01, 95%CI: 1.42-282.00 and OR 15.97, 95%CI: 1.62-157.32) and treatment being rated as unsuccessful (OR 4.75, 95%CI: 0.94-24.05 and OR 40.69, 95%CI: 2.55-649.03), which was confirmed by a Cox proportional hazards model using time-dependent covariates.
conclusionAny increase in CT lesion volume between day 7 and day 14 was a sensitive marker of a lethal outcome (>50%), supporting a CT rescan each one and 2 weeks after initial detection of IPA. The predictive value exceeded all other biomarkers. Further CT follow-up after response at day 14 was of low additional value. KEY POINTS: • CT evaluation offers good prediction of outcome for invasive pulmonary aspergillosis. • Predictive capability exceeds galactomannan, blood counts, and lesion count. • Any progression between day 7 and day 14 constitutes a high-risk scenario.
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