Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT Chest. (18th February 2021)

• Record Type: Journal Article
• Authors: Burivong, Wanaporn; Sricharoen, Thanatorn; Thachang, Apichart; Soodchuen, Sunsiree; Maroongroge, Panitpong; Leelasithorn, Vichit
• Other Names: Faggioni Lorenzo Academic Editor.
• Is Part Of: Radiology research and practice. Volume 2021(2021)
• Publication Date: 2021-02-18
• Subjects: Radiography -- Periodicals; Radiology -- Periodicals; Medical radiology -- Periodicals; Radiology; Radiography; Radiology; Medical radiology; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.0757
• DOI: 10.1155/2021/8691363
• Languages: English
• ISSNs: 2090-1941

Abstract

Abstract : Objective . The purpose of this study is to compare the early radiologic diagnosis of pulmonary infection between serial chest radiography (chest film) and single chest computed tomography (CT chest) in the first seven days of febrile neutropenia. Methods . This study included 78 patients with hematologic malignancies who developed 107 episodes of febrile neutropenia from January 2012 to October 2017 and had a chest film performed within the first seven days. Demographic and radiographic data were retrospectively reviewed. Three radiologists independently and blindly evaluated chest films and CT chests. The sensitivity, specificity, and correlation of chest film with absolute neutrophil count were carried out. Results . A total of 222 chest films were performed during this period and found thirty-nine episodes (36.4%) of radiographic active pulmonary infection. The diagnosis of clinical positive for pulmonary infection is 44.8% (48/107). Sensitivity, specificity, positive predictive value, and negative predictive value of serial chest film in the early radiologic diagnosis of pulmonary infection are 50%, 74%, 61%, and 64%, respectively. The false-positive rate was 14%, and the false-negative rate was 22%. For single CT chest examinations, twenty-six studies were assessed, and 42.3% was indicative of radiographic active pulmonary infection. Sensitivity, specificity, positive predictive value, and negative predictive value of CT chest in the early radiologic diagnosis of pulmonary infection are 91%, 40%, 53%, and 86%, respectively. The false-positive rate was 60%. The absolute neutrophil count was not useful for predicting radiographic active pulmonary infection. Conclusion . Serial chest film for early radiologic diagnosis of pulmonary infection within the first seven days of febrile neutropenia has lower sensitivity with higher specificity as compared to a single CT chest. Conversely, CT chest may not only have a higher sensitivity in determining early pulmonary infection but also has a higher rate of false-positives.