title: Use and yield of chest computed tomography in the diagnostic evaluation of pediatric lung disease.
abstract: OBJECTIVE
  Computed tomography is commonly used in the diagnosis of pediatric lung disease. Although the radiation is not negligible, the yield has never been studied.
  
  
  METHODS
  Clinical and imaging data were collected for all children who underwent chest computed tomography, as part of the diagnostic process. Cases were grouped according to type of lung disease, based on clinical data and the question addressed to the radiologist. A positive yield was defined as computed tomography providing >or=1 of the following: (1) a diagnosis, (2) a clinically important new finding that had not been recognized previously, (3) alteration of the plan for further evaluation or treatment, or (4) exclusion of lung disease. No yield was defined when computed tomography did not add new information and did not affect evaluation or treatment.
  
  
  RESULTS
  Ages ranged from 2 weeks to 16 years, and 59% were male. The overall positive yield was 61% (64 of 105 cases). Yields were relatively low, that is, 23% (8 of 35 cases) for the evaluation of diffuse lung disease, 46% (6 of 13 cases) for localized disease, 50% (6 of 12 cases) for pleural disease, and 98% (41 of 42 cases) for congenital malformations.
  
  
  CONCLUSIONS
  The yield of chest computed tomography depends on the type of disease. Computed tomography has a significant yield for congenital anomalies. The yield is particularly low in the evaluation of acquired diffuse pulmonary disease and is relatively low in acquired focal lung disease. We suggest that chest computed tomography be used more judiciously.
authors.affiliation: aDepartment of Pediatric Pulmonology, Critical Care and SleepMedicine, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Nira
authors.initials: N
authors.lastname: Schneebaum
authors.forename: Hannah
authors.initials: H
authors.lastname: Blau
authors.forename: Ruth
authors.initials: R
authors.lastname: Soferman
authors.forename: Huda
authors.initials: H
authors.lastname: Mussaffi
authors.forename: Liat
authors.initials: L
authors.lastname: Ben-Sira
authors.forename: Michael
authors.initials: M
authors.lastname: Schwarz
authors.forename: Yakov
authors.initials: Y
authors.lastname: Sivan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*