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Baseline Chest Computed Tomography as Standard of Care in High-Risk Hematology Patients.


ABSTRACT: Baseline chest computed tomography (BCT) in high-risk hematology patients allows for the early diagnosis of invasive pulmonary aspergillosis (IPA). The distribution of BCT implementation in hematology departments and impact on outcome is unknown. A web-based questionnaire was designed. International scientific bodies were invited. The estimated numbers of annually treated hematology patients, chest imaging timepoints and techniques, IPA rates, and follow-up imaging were assessed. In total, 142 physicians from 43 countries participated. The specialties included infectious diseases (n = 69; 49%), hematology (n = 68; 48%), and others (n = 41; 29%). BCT was performed in 57% (n = 54) of 92 hospitals. Upon the diagnosis of malignancy or admission, 48% and 24% performed BCT, respectively, and X-ray was performed in 48% and 69%, respectively. BCT was more often used in hematopoietic cell transplantation and in relapsed acute leukemia. European centers performed BCT in 59% and non-European centers in 53%. Median estimated IPA rate was 8% and did not differ between BCT (9%; IQR 5-15%) and non-BCT centers (7%; IQR 5-10%) (p = 0.69). Follow-up computed tomography (CT) for IPA was performed in 98% (n = 90) of centers. In high-risk hematology patients, baseline CT is becoming a standard-of-care. Chest X-ray, while inferior, is still widely used. Randomized, controlled trials are needed to investigate the impact of BCT on patient outcome.

SUBMITTER: Stemler J 

PROVIDER: S-EPMC7151030 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Baseline Chest Computed Tomography as Standard of Care in High-Risk Hematology Patients.

Stemler Jannik J   Bruns Caroline C   Mellinghoff Sibylle C SC   Alakel Nael N   Akan Hamdi H   Ananda-Rajah Michelle M   Auberger Jutta J   Bojko Peter P   Chandrasekar Pranatharthi H PH   Chayakulkeeree Methee M   Cozzi José A JA   de Kort Elizabeth A EA   Groll Andreas H AH   Heath Christopher H CH   Henze Larissa L   Hernandez Jimenez Marcos M   Kanj Souha S SS   Khanna Nina N   Koldehoff Michael M   Lee Dong-Gun DG   Mager Alina A   Marchesi Francesco F   Martino-Bufarull Rodrigo R   Nucci Marcio M   Oksi Jarmo J   Pagano Livio L   Phillips Bob B   Prattes Juergen J   Pyrpasopoulou Athina A   Rabitsch Werner W   Schalk Enrico E   Schmidt-Hieber Martin M   Sidharthan Neeraj N   Soler-Palacín Pere P   Stern Anat A   Weinbergerová Barbora B   El Zakhem Aline A   Cornely Oliver A OA   Koehler Philipp P  

Journal of fungi (Basel, Switzerland) 20200313 1


Baseline chest computed tomography (BCT) in high-risk hematology patients allows for the early diagnosis of invasive pulmonary aspergillosis (IPA). The distribution of BCT implementation in hematology departments and impact on outcome is unknown. A web-based questionnaire was designed. International scientific bodies were invited. The estimated numbers of annually treated hematology patients, chest imaging timepoints and techniques, IPA rates, and follow-up imaging were assessed. In total, 142 p  ...[more]

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