Pediatric pneumonia: will lung ultrasound replace X-ray?
March 19, 2018
Pediatrics
Ultrasound
X-Ray
From the March 2018 issue of HealthCare Business News magazine
The results, which were published in the journal Chest in July 2016, revealed a 38.8 percent reduction in chest X-rays in the first group and no missed cases of pneumonia or increases in adverse events. This reduction saved the hospital $9,200 and the length of stay in the emergency department was cut by 26 minutes.
“In my emergency department, the wait could be anywhere from 30 minutes, if we aren’t busy, up to three hours to get a chest X-ray, especially during flu season,” says Tsung. “If I have a portable ultrasound machine with me, I can get my answers within five minutes.”
A team of researchers in Belgium also studied the performance of lung ultrasound for diagnosing pediatric pneumonia. The results were published in the European Journal of Radiology in March 2017.
The study evaluated 143 children between September 2013 and June 2014 with a mean age of 3 years. Each child underwent lung ultrasound and the radiologists interpreting the images were blinded to the prior chest X-ray results.
Of the 59 areas of lung consolidation (a symptom of pneumonia) that X-ray detected, ultrasound was able to detect 54. In the eight patients with negative X-ray results, ultrasound detected 17 areas of consolidation.
The mean size of consolidations only visible with ultrasound was 9.4 millimeters and the mean size of those visible with both techniques was 26 millimeters, meaning ultrasound detected smaller infections that X-ray missed.
“Thanks to its high negative predictive value, [ultrasound] can be a first-line imaging technique,” says Dr. Anne-Sophie Claes, one of the researchers and faculty of the Université Catholique de Louvain in Brussels, Belgium.
She and Tsung both believe that ultrasound has the ability to replace chest X-ray for detecting pediatric pneumonia.
“Based on the research I have done, I’m pretty much convinced that lung ultrasound can replace chest X-ray,” says Tsung. “It’s just a matter of getting other doctors to adopt it.”
Getting ultrasound where it’s needed most
A new ultrasound system can easily cost upwards of $100,000, but manufacturers have made significant headway in recent years toward simplified and portable ultrasound solutions at a fraction of that price. These relatively lightweight modalities are entering regions where imaging is sorely lacking.
The results, which were published in the journal Chest in July 2016, revealed a 38.8 percent reduction in chest X-rays in the first group and no missed cases of pneumonia or increases in adverse events. This reduction saved the hospital $9,200 and the length of stay in the emergency department was cut by 26 minutes.
“In my emergency department, the wait could be anywhere from 30 minutes, if we aren’t busy, up to three hours to get a chest X-ray, especially during flu season,” says Tsung. “If I have a portable ultrasound machine with me, I can get my answers within five minutes.”
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A team of researchers in Belgium also studied the performance of lung ultrasound for diagnosing pediatric pneumonia. The results were published in the European Journal of Radiology in March 2017.
The study evaluated 143 children between September 2013 and June 2014 with a mean age of 3 years. Each child underwent lung ultrasound and the radiologists interpreting the images were blinded to the prior chest X-ray results.
Philips Healthcare's Lumify portable ultrasound machine.
Of the 59 areas of lung consolidation (a symptom of pneumonia) that X-ray detected, ultrasound was able to detect 54. In the eight patients with negative X-ray results, ultrasound detected 17 areas of consolidation.
The mean size of consolidations only visible with ultrasound was 9.4 millimeters and the mean size of those visible with both techniques was 26 millimeters, meaning ultrasound detected smaller infections that X-ray missed.
“Thanks to its high negative predictive value, [ultrasound] can be a first-line imaging technique,” says Dr. Anne-Sophie Claes, one of the researchers and faculty of the Université Catholique de Louvain in Brussels, Belgium.
She and Tsung both believe that ultrasound has the ability to replace chest X-ray for detecting pediatric pneumonia.
“Based on the research I have done, I’m pretty much convinced that lung ultrasound can replace chest X-ray,” says Tsung. “It’s just a matter of getting other doctors to adopt it.”
Getting ultrasound where it’s needed most
A new ultrasound system can easily cost upwards of $100,000, but manufacturers have made significant headway in recent years toward simplified and portable ultrasound solutions at a fraction of that price. These relatively lightweight modalities are entering regions where imaging is sorely lacking.
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