title: Chest low-dose computed tomography in neutropenic acute myeloid leukaemia patients.
abstract: BACKGROUND
  We aimed to compare chest low-dose computed tomography (LDCT) with chest radiography (CXR) in the assessment of febrile acute myeloid leukaemia neutropenic patients.
  
  
  METHODS
  A prospective non-randomized study was carried out between 30 May, 2003 and 3 June, 2004 in consecutive neutropenic patients who required imaging of the thorax and were treated for acute myeloid leukaemia. Each patient had a baseline 2-view chest radiograph followed by LDCT. Both the CXR and the LDCT studies were blindly and independently reviewed by two chest radiologists.
  
  
  RESULTS
  Forty patients were enrolled: 24 male and 16 female, mean age 53.5 years (range 18-83) and an average neutrophil count of 0.78 x 10(9)/L. Patients had CXR within a mean of 40 min from the LDCT. Overall, 31 (77.5%) of 40 CXR were abnormal, whereas LDCT detected abnormalities in 38 (95%) of 40 patients. LDCT demonstrated three times the number of lung nodules as CXR and twice as many ground-glass opacities. Lung consolidation was detected similarly using both techniques, but LDCT demonstrated more extensive and multi-focal consolidation. The majority of nodules detected only on LDCT were subcentimetre in diameter. The additional information provided by LDCT led to an alteration in the clinical management of 11 (27.5%) of 40 patients.
  
  
  CONCLUSIONS
  LDCT is a useful tool in the initial investigation of suspected pulmonary complication in neutropenic patients. This is supported by the additional information it provides to the CXR with reduced radiation when compared to conventional CT.
authors.affiliation: Department of Medical Imaging, University Health Network, Toronto General Hospital, Toronto, ON M5G 2C4, Canada. nimrod.maimon@gmail.com
authors.forename: Demetris
authors.initials: D
authors.lastname: Patsios
authors.forename: Nimrod
authors.initials: N
authors.lastname: Maimon
authors.forename: TaeBong
authors.initials: T
authors.lastname: Chung
authors.forename: Heidi
authors.initials: H
authors.lastname: Roberts
authors.forename: Patricia
authors.initials: P
authors.lastname: Disperati
authors.forename: Mark
authors.initials: M
authors.lastname: Minden
authors.forename: Narinder
authors.initials: N
authors.lastname: Paul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult