A new research study demonstrated that lung ultrasound is a novel, efficient and safe option for the diagnosis of pneumonia, representing an alternative to chest X-ray in children. The study, “Feasibility and Safety of Substituting Lung Ultrasound for Chest X-ray When Diagnosing Pneumonia in Children: A Randomized Controlled Trial,” was conducted at the Icahn School of Medicine at Mount Sinai, and was published in the journal Chest.
The World Health Organization reports pneumonia as the primary cause of death among children all over the word. Children with pneumonia may initially present with fever, cough, and tachypnea. These signs and symptoms, however, often occur in viral pulmonary infections, and therefore do not reliably predict bacterial pneumonia.
Chest X-ray is a frequently applied and reliable method for the diagnosis of pneumonia at early ages. However, according to the WHO, 75 percent of the population has no access to X-ray. On the other hand, lung ultrasound has been shown to be an accurate method for the diagnosis of pneumonia in children, and could be considered an alternative to X-ray.
The team conducted a randomized, controlled clinical study in the pediatric Emergency Department at Mount Sinai Hospital to compare X-ray to lung ultrasound as a diagnostic method for pneumonia in 191 children from infants to age 21. The patients in the investigational group underwent a lung ultrasound, followed by a chest X-ray if the doctor required further confirmation. In the control group, patients underwent chest X-ray followed by a lung ultrasound.
Investigators found that the number of chest X-rays dropped by 39 percent in the investigational group, where patients were submitted to a lung ultrasound first.
“Ultrasound is portable, cost-saving, and safer for children than an X-ray because it does not expose them to radiation,” said Dr. James Tsung, M.D., MPH, the study’s lead author, associate professor in the Department of Emergency Medicine and Department of Pediatrics at the Icahn School of Medicine at Mount Sinai, and assistant professor in the Department of Pediatrics at Vanderbilt University School of Medicine, in a news release. “Our study could have a profound impact in the developing world where access to radiography is limited.”
The investigation also revealed that the reduction in the number of chest X-rays in the investigational group lowered the overall cost of by $9,200, and the length of stay in the Emergency Department was shortened by 26 minutes.
“In the era of precision medicine, lung ultrasound may also be an ideal imaging option in children who are at higher risk for radiation-induced cancers or have received multiple radiographic or CT imaging studies,” Tsung said.
The findings highlight that lung ultrasound can be an important alternative for diagnosing pneumonia in children, especially since current available ultrasound machines can be carried by a single person. Still, further investigation is required to confirm the efficiency and impact of applying lung ultrasound as a diagnostic tool.