Pleuro-pulmonary ultrasound in the diagnosis and follow-up of lung
infections in children with cancer: a pilot sudy
Abstract
Febrile neutropenia and lung infections are common and potential fatal
complications of pediatric cancer patients during chemotherapy. Lung
ultrasound (LUS) has a good accurancy in the diagnosis of pneumonia in
childhood. To our knowledge there are no studies concerning its
utilization in the diagnosis and follow-up of pulmonary infection in
children with cancer. The goal of this pilot study is to determine the
accuracy of lung ultrasonography for the diagnosis and follow up of
pneumonia in children and adolescents with cancer during fever. This is
a prospective observational case-control monocentric study conducted in
the Pediatric Hematology and Oncology Department of University Hospital
of Catania in patients aged<18 years with cancer, with or
without fever. Attending Physician used ultrasonography to diagnose
pneumonia in children with cancer during fever. Non infected cancer
patients were also tested with LUS to evaluate its accuracy. When
performed, the results of chest X-ray and chest CT scan were compared
with LUS results. Thirty-eight patients were studied. All underwent LUS,
16 underwent CXR, 3 chest CT. Statistical analysis showed LUS
specificity of 95%, and sensitivity of 100%; CXR, instead showed a
specificity of 80% and a sensitivity of 50%. The positive predictive
value of LUS was 90% while that of CXR was 50%. The negative
predictive value of LUS was 100% while that of CXR was 80%.This study
shows for the first time that LUS allows physicians to diagnose
pneumonia in children and young adults with cancer, with high
specificity and sensitivity.