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Clinical utility of surveillance computed tomography scans in infants with cystic fibrosis
Author(s) -
Newbegin Katy,
Pilkington Katie,
Shanthikumar Shivanthan,
Ranganathan Sarath
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24132
Subject(s) - medicine , bronchiectasis , asymptomatic , cystic fibrosis , radiology , medical record , lung , computed tomography , cohort , surgery
Background In cystic fibrosis (CF), irreversible lung disease arises in early life, and is often asymptomatic and unrecognised. Chest computed tomography (CT) scans have been used to detect asymptomatic lung disease in research; however, the clinical utility of chest CT is unknown. This study aimed to determine the effect of surveillance CT in early life on the clinical management of patients with CF. Working Hypothesis Surveillance CT in early life changes the management of patients with CF. Methods A medical record review of patients in the AREST‐CF cohort who had chest CT at 1 and 3 years of age was performed. Information extracted included CT scan findings and the effect of CT results on clinical management. Results The chest CT scans and records of 50 subjects with CF were reviewed. The majority of CT scans ( n = 75; 75%) were abnormal. N = 31 (31%) of scans overall led to a direct change in management. The number of CT scans needed to be performed to lead to a treatment change was 3.2. The majority ( n = 18, 58%) of changes in management were prompted by the finding of bronchiectasis. Conclusion To the authors knowledge, this is the first study to highlight that early life surveillance CT frequently results in changes in clinical management, and hence may have a role beyond research and in routine care. If this can be shown to contribute to improved outcomes (such as reduced rates of bronchiectasis), then, as radiation doses diminish, chest CT could have an important clinical role.