Evidence map›Paper›PMID 39688678›Full record

ArticlePediatric radiology2025

How accurate is high-resolution computed tomography of the chest in differentiating between pulmonary invasive fungal infections and other pulmonary infections in children with cancer?

Janine Nijhuis, Geertje P Verduin, Tom F W Wolfs, Tineke T Stolk, Daniela Cianci, Laura G Y Rotte, Caroline A Lindemans, Louis J Bont, Rutger A J Nievelstein

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Article in Pediatric radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Janine NijhuisPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Geertje P VerduinWilhelmina Children's Hospital, UMC Utrecht, University Utrecht, Utrecht, The Netherlands.
Tom F W WolfsPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. t.wolfs@umcutrecht.nl.
Tineke T StolkPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Daniela CianciJulius Center for Health Sciences and Primary Care, Department of Data Science & Biostatistics, UMC Utrecht, Utrecht University, Utrecht, The Netherlands.
Laura G Y RottePrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Caroline A LindemansPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Louis J BontPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Rutger A J NievelsteinPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. R.A.J.Nievelstein@umcutrecht.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPulmonary invasive fungal infections pose a serious risk for immunocompromised patients. Although diagnostic imaging plays an important role in the early detection of pulmonary invasive fungal infections, radiological differentiation between invasive fungal infection and other pulmonary infections is challenging.

objectiveThe aim of this study was to assess the accuracy of chest high-resolution computed tomography (HRCT) in the differentiation between pulmonary invasive fungal infections and other pulmonary infections in paediatric cancer patients. MATERIALS AND

methodsIn this retrospective study, baseline HRCTs of patients with probable or proven invasive fungal infections and other pulmonary infections were blindly assessed by two radiologists, followed by a consensus reading. The scoring form included imaging characteristics and radiological invasive fungal infection probability assessment. Inter-rater reliability was determined with Cohen's kappa.

resultsChest HRCTs (n = 77) of paediatric cancer patients with pulmonary invasive fungal infections (n = 45) and with other pulmonary infections (n = 32) were evaluated. In the consensus reading, nodules with halo sign and wedge-shaped consolidations were observed significantly more in pulmonary invasive fungal infections than in other pulmonary infections (86.7% vs. 34.4% and 28.9% vs. 9.4%), and ground-glass opacities were observed less frequently (61.4% vs. 87.5%). The kappa values for the individual imaging characteristics ranged from 0.121 to 0.408. Sensitivity of the HRCT to diagnose a pulmonary invasive fungal infection ranged from 0.78 to 0.80, and specificity from 0.66 to 0.88.

conclusionThe accuracy of chest HRCTs in differentiating between invasive fungal infections and other pulmonary infections is poor. There are two main reasons for this: no individual imaging characteristic was found to be able to fully distinguish between invasive fungal infections and other pulmonary infections, and the agreement between radiologists was only moderate.

Indexed as

Invasive Fungal InfectionsLung Diseases, FungalNeoplasmsRadiography, ThoracicTomography, X-Ray ComputedAdolescentChildChild, PreschoolDiagnosis, DifferentialFemaleHumansInfantMaleReproducibility of ResultsRetrospective StudiesSensitivity and SpecificityChildrenComputed tomographyInvasive fungal infectionLungOncology

Identifiers

PMID39688678

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.