Parametric Response Mapping as an Indicator of Bronchiolitis Obliterans Syndrome after Hematopoietic Stem Cell Transplantation Craig J. Galbán, Jennifer.

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Parametric Response Mapping as an Indicator of Bronchiolitis Obliterans Syndrome after Hematopoietic Stem Cell Transplantation Craig J. Galbán, Jennifer L. Boes, Maria Bule, Carrie L. Kitko, Daniel R. Couriel, Timothy D. Johnson, Vihba Lama, Eef D. Telenga, Maarten van den Berge, Alnawaz Rehemtulla, Ella A. Kazerooni, Michael J. Ponkowski, Brian D. Ross, Gregory A. Yanik Biology of Blood and Marrow Transplantation Volume 20, Issue 10, Pages 1592-1598 (October 2014) DOI: 10.1016/j.bbmt.2014.06.014 Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Schematic diagram of the PRM workflow. Biology of Blood and Marrow Transplantation 2014 20, 1592-1598DOI: (10.1016/j.bbmt.2014.06.014) Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Pulmonary complications identified by PRM. Normal lung tissue is denoted green (PRMNormal), functional small airway disease yellow (PRMfSAD), emphysematous changes red (PRMEmph), and parenchymal disease purple (PRMPD). PRMfSAD and PRMPD values are provided at the bottom of PRM images (values are color coded to disease component). (A) Healthy age-matched, nontransplant control subjects. (B) Fungal pneumonitis, 61 days post-HCT. (C) BOS at NIH-CC–defined onset, 448 days post-HCT. No concurrent infection present. (D) Pseudomonas pneumonitis in a patient with previously documented BOS, now 447 days post-HCT. Biology of Blood and Marrow Transplantation 2014 20, 1592-1598DOI: (10.1016/j.bbmt.2014.06.014) Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 Group comparisons in pulmonary function measures and PRM. Bar plots are used to present the group differences observed in PRM measurements, PRMNormal, PRMfSAD, and PRMPD. Statistical significance was assessed at P < .05 and denoted by an asterisk. Data are presented as means ± SEM. Biology of Blood and Marrow Transplantation 2014 20, 1592-1598DOI: (10.1016/j.bbmt.2014.06.014) Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 Onset and progression of BOS post-HCT in a single patient. (A) Representative PRM axial slices are provided at discrete time points after HCT. (B) Line plot with axes time (years) and PRM relative lung volumes (%) at various time points post-HCT. Biology of Blood and Marrow Transplantation 2014 20, 1592-1598DOI: (10.1016/j.bbmt.2014.06.014) Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions