The Use of Low-Dose Chest Computed Tomography for the Diagnosis and Monitoring of Pulmonary Infections in Patients with Hematologic Malignancies

Author:

Agadakos Efthimios1ORCID,Zormpala Alexandra1,Zaios Nikolaos2,Kapsiocha Chrysoula1,Gamaletsou Maria N.3,Voulgarelis Michael3,Sipsas Nikolaos V.3ORCID,Moulopoulos Lia Angela2,Koutoulidis Vassilis2

Affiliation:

1. Department of Radiology, General Hospital of Athens Laiko, 11527 Athens, Greece

2. First Department of Radiology, School of Medicine, Areteion Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece

3. Department of Pathophysiology, General Hospital of Athens Laiko, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece

Abstract

The study aimed to assess the image quality and diagnostic performance of low-dose Chest Computed Tomography (LDCCT) in detecting pulmonary infections in patients with hematologic malignancies. A total of 164 neutropenic patients underwent 256 consecutive CT examinations, comparing 149 LDCCT and 107 Standard-Dose Chest CT (SDCCT) between May 2015 and June 2019. LDCCT demonstrated a 47% reduction in radiation dose while maintaining acceptable image noise and quality compared to SDCCT. However, LDCCT exhibited lower sensitivity in detecting consolidation (27.5%) and ground glass opacity (64.4%) compared to SDCCT (45.8% and 82.2%, respectively) with all the respective p-values from unadjusted and adjusted for sex, age, and BMI analyses being lower than 0.006 and the corresponding Odds Ratios of detection ranging from 0.30 to 0.34. Similar trends were observed for nodules ≥3 mm and ground glass halo in nodules but were not affected by sex, age and BMI. No significant differences were found for cavitation in nodules, diffuse interlobular septal thickening, pleural effusion, pericardial effusion, and lymphadenopathy. In conclusion, LDCCT achieved substantial dose reduction with satisfactory image quality but showed limitations in detecting specific radiologic findings associated with pulmonary infections in neutropenic patients compared to SDCCT.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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