Point of care Thoracic Ultrasound vs. Chest Computed Tomography in the approach of Febrile Neutropenia patients

Abstract

Purpose: Our study aimed to evaluate the correlation between CT and Thoracic Ultrasound (TUS) in detecting pulmonary pathology in immunosuppressed patients. Methods: A single center prospective study was conducted. Consecutive patients with febrile neutropenia who underwent CT underwent TUS evaluation within 24h after CT. Both studies were performed by an expert who was blinded to the clinical information and results of the alternative imaging modalities. Results: 34 patients met the eligibility criteria. The median age was 39.9 years (±17 SD). TUS as a diagnostic test had a sensitivity of 92.9% and specificity of 83.3%, negative predictive value (NPV) of 71.4%, and positive predictive value of 96.3%. Good concordance was demonstrated with a kappa of 0.71 (p = 0.001) between the TUS and chest CT findings. We obtained a kappa of 1 (p = 0.001) for the final diagnosis of Pleural Effusion (PE). Conclusion: TUS is a promising screening test for immunocompromised individuals. The results showed a good correlation between CT and TUS diagnoses for the detection of pulmonary findings and high sensitivity.