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Emergency Radiology
Published in: Emergency Radiology 4/2020

Open Access 01-08-2020 | Bronchoscopy | Original Article

Diagnosis of foreign body aspiration with ultralow-dose CT using a tin filter: a comparison study

Authors: Lena Gordon, Patrik Nowik, Shahla Mobini Kesheh, Marika Lidegran, Sandra Diaz

Published in: Emergency Radiology | Issue 4/2020

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Abstract

Purpose

Suspected airway foreign body aspiration (FBA) is a common event in paediatric emergency units, especially in children under 3 years of age. It can be a life-threatening event if not diagnosed promptly and accurately. The purpose of this study is to compare the diagnostic performance of an ultralow-dose CT (DLP of around 1 mGycm) with that of conventional radiographic methods (fluoroscopy and chest radiography of the airways) in the diagnosis of FBA children’s airways.

Methods

Retrospective cross-sectional study. Data from 136 children were collected: 75 were examined with conventional radiographic methods and 61 with ultralow-dose CT. Effective doses were compared using independent t tests. The results of bronchoscopy, if performed, were used in creating contingency 2 × 2 tables to assess the diagnostic performance between modalities. An extra triple reading of all images was applied for this purpose.

Results

The effective doses used in the ultralow-dose CT examinations were lower compared with those in conventional methods (p < 0.001). The median dose for CT was 0.04 mSv compared with 0.1 mSv for conventional methods. Sensitivity and specificity were higher for ultralow-dose CT than those for conventional methods (100% and 98% versus 33% and 96%) as were the positive and negative predicted values (90% and 100% versus 60% and 91%).

Conclusion

Ultralow-dose CT can be used as the imaging of choice in the diagnosis of airway FBA in emergency settings, thereby avoiding concerns about radiation doses and negative bronchoscopy outcomes.
Literature
1.
Hitter A et al (2011) Diagnostic value of various investigations in children with suspected foreign body aspiration: review. Eur Ann Otorhinolaryngol Head Neck Dis 128(5):248–252CrossRef
2.
Kalender WA (2005) CT: the unexpected evolution of an imaging modality. Eur Radiol 15(Suppl 4):D21–D24CrossRef
3.
Gordic S, Morsbach F, Schmidt B, Allmendinger T, Flohr T, Husarik D, Baumueller S, Raupach R, Stolzmann P, Leschka S, Frauenfelder T, Alkadhi H (2014) Ultralow-dose chest computed tomography for pulmonary nodule detection: first performance evaluation of single energy scanning with spectral shaping. Investig Radiol 49(7):465–473CrossRef
4.
Tapiovaara MJ (2008) Review of relationships between physical measurements and user evaluation of image quality. Radiat Prot Dosim 129(1–3):244–248CrossRef
5.
Kadmon G et al (2008) Computerized scoring system for the diagnosis of foreign body aspiration in children. Ann Otol Rhinol Laryngol 117(11):839–843CrossRef
6.
Bhat KV, Hegde JS, Nagalotimath US, Patil GC (2010) Evaluation of computed tomography virtual bronchoscopy in paediatric tracheobronchial foreign body aspiration. J Laryngol Otol 124(8):875–879CrossRef
7.
Bai W, Zhou X, Gao X, Shao C, Califano JA, Ha PK (2011) Value of chest CT in the diagnosis and management of tracheobronchial foreign bodies. Pediatr Int 53(4):515–518CrossRef
8.
Jung SY, Pae SY, Chung SM, Kim HS (2012) Three-dimensional CT with virtual bronchoscopy: a useful modality for bronchial foreign bodies in pediatric patients. Eur Arch Otorhinolaryngol 269(1):223–228CrossRef
9.
Boufersaoui A, Smati L, Benhalla KN, Boukari R, Smail S, Anik K, Aouameur R, Chaouche H, Baghriche M (2013) Foreign body aspiration in children: experience from 2624 patients. Int J Pediatr Otorhinolaryngol 77(10):1683–1688CrossRef
10.
Behera G, Tripathy N, Maru YK, Mundra RK, Gupta Y, Lodha M (2014) Role of virtual bronchoscopy in children with a vegetable foreign body in the tracheobronchial tree. J Laryngol Otol 128(12):1078–1083CrossRef
11.
Hegde SV, Hui PK, Lee EY (2015) Tracheobronchial foreign bodies in children: imaging assessment. Semin Ultrasound CT MR 36(1):8–20CrossRef
12.
Yang C, Hua R, Xu K, Hua X, Ma P, Zheng JN, Li SD, Li JS, Rong YT, Hu CF, Lu X, Ma H, Chen GH, Quan Q (2015) The role of 3D computed tomography (CT) imaging in the diagnosis of foreign body aspiration in children. Eur Rev Med Pharmacol Sci 19(2):265–273PubMed
13.
Gibbons AT, Casar Berazaluce AM, Hanke RE, McNinch N, Person A, Mehlman T, Rubin M, Ponsky TA (2020) Avoiding unnecessary bronchoscopy in children with suspected foreign body aspiration using computed tomography. J Pediatr Surg 55(1):176–181CrossRef
14.
Reid A et al (2020) Ten years of paediatric airway foreign bodies in Western Australia. Int J Pediatr Otorhinolaryngol 129:109760CrossRef
15.
Adaletli I, Kurugoglu S, Ulus S, Ozer H, Elicevik M, Kantarci F, Mihmanli I, Akman C (2007) Utilization of low-dose multidetector CT and virtual bronchoscopy in children with suspected foreign body aspiration. Pediatr Radiol 37(1):33–40CrossRef
16.
Manach Y, Pierrot S, Couloigner V, Ayari-Khalfallah S, Nicollas R, Venail F, Pondaven S, Baculard F, Tantcheu V (2013) Diagnostic performance of multidetector computed tomography for foreign body aspiration in children. Int J Pediatr Otorhinolaryngol 77(5):808–812CrossRef
17.
Pitiot V, Grall M, Ploin D, Truy E, Ayari Khalfallah S (2017) The use of CT-scan in foreign body aspiration in children: a 6 years’ experience. Int J Pediatr Otorhinolaryngol 102:169–173CrossRef
18.
Ahmed OG, Guillerman RP, Giannoni CM (2018) Protocol incorporating airway CT decreases negative bronchoscopy rates for suspected foreign bodies in pediatric patients. Int J Pediatr Otorhinolaryngol 109:133–137CrossRef
19.
Tuckett P, Cervin A (2015) Reducing the number of rigid bronchoscopies performed in suspected foreign body aspiration cases via the use of chest computed tomography: is it safe? A literature review. J Laryngol Otol 129(Suppl 1):S1–S7CrossRef
20.
Nowik P et al (2017) The dosimetric impact of including the patient table in CT dose estimates. Phys Med Biol 62(23):N538–N547CrossRef
Metadata
Title
Diagnosis of foreign body aspiration with ultralow-dose CT using a tin filter: a comparison study
Authors
Lena Gordon
Patrik Nowik
Shahla Mobini Kesheh
Marika Lidegran
Sandra Diaz
Publication date
01-08-2020
Publisher
Springer International Publishing
Published in
Emergency Radiology / Issue 4/2020
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI
https://doi.org/10.1007/s10140-020-01764-7

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