Limited Clinical Impact of Ultralow-Dose Computed Tomography in Suspected Community-Acquired Pneumonia

Tjitske S R van Engelen; Maadrika M N P Kanglie; Inge A H van den Berk; Josje Altenburg; Marcel G W Dijkgraaf; Patrick M M Bossuyt; Jaap Stoker; Jan M Prins; OPTIMACT Study Group

doi:10.1093/ofid/ofad215

Limited Clinical Impact of Ultralow-Dose Computed Tomography in Suspected Community-Acquired Pneumonia

Open Forum Infect Dis. 2023 Apr 20;10(5):ofad215. doi: 10.1093/ofid/ofad215. eCollection 2023 May.

Authors

Tjitske S R van Engelen¹, Maadrika M N P Kanglie², Inge A H van den Berk², Josje Altenburg³, Marcel G W Dijkgraaf⁴, Patrick M M Bossuyt⁴, Jaap Stoker², Jan M Prins¹; OPTIMACT Study Group

Collaborators

OPTIMACT Study Group:
Jouke Annema, Ludo F M bBeenen, Dominique Bekebrede-Kaufman, Joost W van den Berg, Sophie J Bernelot Moens, Shandra Bipat, Bart G Boerrigter, Marije M K Bomers, Marjolein A W van den Boogert, Merel L J Bouwman, Paul Bresser, Annemieke K van den Broek, Brenda Elzer, Jos Donkers, Elvin Eryigit, Betty Frankemölle, Nina-Suzanne Groeneveld, Maarten Groenink, Emo E van Halsema, Naomi M Haverkamp Begemann, Suzanne M R Höchheimer, David Ten Hoff, Frits Holleman, Erwin Hoolwerf, Dorine Hulzebosch, Mitran Keijzers, Saskia Kolkman, Jos A J Kooter, Daniel A Korevaar, Ivo van der Lee, Nick H J Lobe, Peter A Leenhouts, Ramon B van Loon, Paul Luijendijk, Melanie A Monraats, Bregje Mol, Jan Luitse, Lilian J Meijboom, Carmen M Melaan, Saskia Middeldorp, Alexander Montauban van Swijndregt, Wouter de Monyé, Jacqueline Otker, Anna Pijning, Tom van der Poll, Adrienne van Randen, Tom D Y Reijnders, Milan L Ridderikhof, Johannes A Romijn, Jorien M van Rooijen, Maeke J Scheerder, Antoinet J N Schoonderwoerd, Laura J Schijf, Frank F Smithuis, Ralf W Sprengers, Robin Soetekouw, Geert J Streekstra, Elizabeth M Taal, Milou M Tjong Joe Wai, Merve S Tulek, Glenn de Vries, Daphne D L van der Velden, Saskia Veldkamp, Loek Verdegaal, Maaike J A Vogel, Lonneke A van Vught, Mart Vuurboom, Guus A Westerhof, Pieta C Wijsman, Michiel M Winter, Rosa D Wouda, Ibtisam Yahya

Affiliations

¹ Department of Internal Medicine, Division of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.
² Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.
³ Department of Pulmonary Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.
⁴ Department of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.

Abstract

Patients clinically suspected of community-acquired pneumonia (CAP) were randomized between ultralow-dose chest computed tomography ([ULDCT] 261 patients) and chest radiograph ([CXR] 231 patients). We did not find evidence that performing ULDCT instead of CXR affects antibiotic treatment policy or patient outcomes. However, in a subgroup of afebrile patients, there were more patients diagnosed with CAP in the ULDCT group (ULDCT, 106 of 608 patients; CXR, 71 of 654 patients; P = .001).

Keywords: adult; clinical decision making; emergency service; pneumonia; radiography.