Baseline chest computed tomography as standard of care in high‐risk hematology patients

Jannik Stemler, Caroline Bruns, Sibylle C. Mellinghoff, Nael Alakel, Hamdi Akan, Michelle Ananda‐rajah, Jutta Auberger, Peter Bojko, Pranatharthi H. Chandrasekar, Methee Chayakulkeeree, José A. Cozzi, Elizabeth A. de Kort, Andreas H. Groll, Christopher H. Heath, Larissa Henze, Marcos Hernandez Jimenez, Souha S. Kanj, Nina Khanna, Michael Koldehoff, Dong Gun LeeAlina Mager, Francesco Marchesi, Rodrigo Martino‐bufarull, Marcio Nucci, Jarmo Oksi, Livio Pagano, Bob Phillips, Juergen Prattes, Athina Pyrpasopoulou, Werner Rabitsch, Enrico Schalk, Martin Schmidt‐hieber, Neeraj Sidharthan, Pere Soler‐palacín, Anat Stern, Barbora Weinbergerová, Aline El Zakhem, Oliver A. Cornely, Philipp Koehler

    Research output: Contribution to journalArticle

    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.

    Original languageEnglish
    Article number36
    JournalJournal of Fungi
    Volume6
    Issue number1
    DOIs
    Publication statusPublished - Mar 2020

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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., de Kort, E. A., Groll, A. H., Heath, C. H., Henze, L., Jimenez, M. H., Kanj, S. S., Khanna, N., Koldehoff, M., ... Koehler, P. (2020). Baseline chest computed tomography as standard of care in high‐risk hematology patients. Journal of Fungi, 6(1), [36]. https://doi.org/10.3390/jof6010036