Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT Chest
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 hematol...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Radiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/8691363 |
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| author | Wanaporn Burivong Thanatorn Sricharoen Apichart Thachang Sunsiree Soodchuen Panitpong Maroongroge Vichit Leelasithorn |
| author_facet | Wanaporn Burivong Thanatorn Sricharoen Apichart Thachang Sunsiree Soodchuen Panitpong Maroongroge Vichit Leelasithorn |
| author_sort | Wanaporn Burivong |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-67d721d8624c4d958c714912d88a8cfb |
| institution | Kabale University |
| issn | 2090-1941 2090-195X |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Radiology Research and Practice |
| spelling | doaj-art-67d721d8624c4d958c714912d88a8cfb2025-02-03T06:46:01ZengWileyRadiology Research and Practice2090-19412090-195X2021-01-01202110.1155/2021/86913638691363Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT ChestWanaporn Burivong0Thanatorn Sricharoen1Apichart Thachang2Sunsiree Soodchuen3Panitpong Maroongroge4Vichit Leelasithorn5Department of Radiology, Faculty of Medicine, Srinakharinwirot University, Bangkok, ThailandDepartment of Radiology, Faculty of Medicine, Srinakharinwirot University, Bangkok, ThailandDepartment of Radiology, Faculty of Medicine, Srinakharinwirot University, Bangkok, ThailandDepartment of Radiology, Faculty of Medicine, Srinakharinwirot University, Bangkok, ThailandDepartment of Radiology, Faculty of Medicine, Srinakharinwirot University, Bangkok, ThailandDepartment of Radiology, Faculty of Medicine, Srinakharinwirot University, Bangkok, ThailandObjective. 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.http://dx.doi.org/10.1155/2021/8691363 |
| spellingShingle | Wanaporn Burivong Thanatorn Sricharoen Apichart Thachang Sunsiree Soodchuen Panitpong Maroongroge Vichit Leelasithorn Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT Chest Radiology Research and Practice |
| title | Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT Chest |
| title_full | Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT Chest |
| title_fullStr | Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT Chest |
| title_full_unstemmed | Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT Chest |
| title_short | Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT Chest |
| title_sort | early radiologic diagnosis of pulmonary infection in febrile neutropenic patients a comparison of serial chest radiography and single ct chest |
| url | http://dx.doi.org/10.1155/2021/8691363 |
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