Significance of high-resolution CT findings by using densitometry in patient with pulmonary alveolar proteinosis.

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The aim of this study was to analyze the lung attenuation of ground glass opacity (GGO) by using densitometry on high-resolution CT in patients with pulmonary alveolar proteinosis (PAP). Five cases were enrolled in this study. Inspiratory thin-slice spiral chest CT scans (Aquilion 64, Toshiba medical systems, Japan) were performed. The mean lung attenuation and whole lung volume varied in each severity of PAP cases. According to the histogram feature, the ratio associated with PAP (defined as the ratio of CT lung volume for GGO divided by total CT lung volume) contributed to differentiate PAP lesion from normal area. GGO for the range of density -850 to -750 HU suggested the lesion of PAP on HRCT and the lung volume in this range showed the greatest degree correlation with the levels of serum KL-6 (r=0.867)and CEA (r=0.616). Although it is very difficult to early diagnose as PAP in generally, these results might be practical radiographic findings of diagnostic procedure for PAP.