A New Modality for the Diagnosis of Bleomycin-induced Toxicity: Ultrasonography Nuevo método diagnóstico para la toxicidad inducida por bleomicina: la ecografía
Archivos de Bronconeumologia, cilt.54, sa.12, ss.619-624, 2018 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 54 Sayı: 12
- Basım Tarihi: 2018
- Doi Numarası: 10.1016/j.arbres.2018.06.006
- Dergi Adı: Archivos de Bronconeumologia
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.619-624
- Anahtar Kelimeler: Bleomycin toxicity, High-resolution computed tomography, Ultrasonography
- Maltepe Üniversitesi Adresli: Evet
Özet
Objective: To evaluate the role of ultrasonography (USG) in the diagnosis of bleomycin-induced pulmonary toxicity (BT). Material and methods: The study included patients with suspected BT during treatment with bleomycin due to various oncologic diseases between June 2015 and May 2017. The patients initially underwent clinical and high-resolution computed tomography (HRCT) examinations and pulmonary function tests (PFT)-diffusing capacity of the lung for carbon monoxide (DLCO), followed by registration of USG findings—number of comet tail artifact (CTA) images by a different pulmonologist. We compared the findings from USG, HRCT, and PFT–DLCO tests between BT and non-BT groups. With the diagnosis based on clinical-radiologic and PFT–DLCO assessments taken as the gold standard, we determined the sensitivity and specificity of the USG outcomes for diagnosis of BT. Results: The study included a total of 30 patients. Nine patients were diagnosed as having BT according to their clinical and radiologic findings and PFT–DLCO measurements. The mean number of CTA images was 68.7 ± 22 in patients with BT vs 28.2 ± 9.3 in those without BT (P <.001). The difference in CTA images between the patients with and without ground glass density was statistically significant (28.3 ± 9.5 and 64.6 ± 24.5, respectively, P <.001). In patients with BT, there was a negative correlation between the number of CTAs and DLCO% and FVC% values (P =.004; P =.016). USG had a sensitivity of 100%, and a specificity of 95% diagnosing BT in selected patients. Conclusion: In bleomycin-induced toxicity, USG findings are correlated with HRCT and PFT–DLCO findings, with a remarkably increased number of CTAs in BT. Thoracic USG examination is a diagnostic tool with a high sensitivity and specificity for diagnosing BT.