1. Baseline Chest Computed Tomography as Standard of Care in High-Risk Hematology Patients
- Author
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Stemler, J., Bruns, C., Mellinghoff, S.C., Alakel, N., Akan, H., Ananda-Rajah, M., Auberger, J., Bojko, P., Chandrasekar, P.H., Chayakulkeeree, M., Cozzi, J.A., Kort, E.A. de, Groll, A.H., Heath, C.H., Henze, L., Hernandez Jimenez, M., Kanj, S.S., Khanna, N., Koldehoff, M., Lee, D.G., Mager, A., Marchesi, F., Martino-Bufarull, R., Nucci, M., Oksi, J., Pagano, L., Phillips, B., Prattes, J., Pyrpasopoulou, A., Rabitsch, W., Schalk, E., Schmidt-Hieber, M., Sidharthan, N., Soler-Palacin, P., Stern, A., Weinbergerova, B., El Zakhem, A., Cornely, O.A., Koehler, P., Stemler, J., Bruns, C., Mellinghoff, S.C., Alakel, N., Akan, H., Ananda-Rajah, M., Auberger, J., Bojko, P., Chandrasekar, P.H., Chayakulkeeree, M., Cozzi, J.A., Kort, E.A. de, Groll, A.H., Heath, C.H., Henze, L., Hernandez Jimenez, M., Kanj, S.S., Khanna, N., Koldehoff, M., Lee, D.G., Mager, A., Marchesi, F., Martino-Bufarull, R., Nucci, M., Oksi, J., Pagano, L., Phillips, B., Prattes, J., Pyrpasopoulou, A., Rabitsch, W., Schalk, E., Schmidt-Hieber, M., Sidharthan, N., Soler-Palacin, P., Stern, A., Weinbergerova, B., El Zakhem, A., Cornely, O.A., and Koehler, P.
- Abstract
Contains fulltext : 218254.pdf (publisher's version ) (Open Access), 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.
- Published
- 2020