Guidance for chest-CT in children and adults with cystic fibrosis: A European perspective

Fayon, Michael;Hill, Kate;Waldron, Michael;Messore, Barbara;Riberi, Luca;Svedberg, Marcus;Lammertyn, Elise;Fustik, Stojka;Gramegna, Andrea;Stahl, Mirjam;Kerpel-Fronius, Anna;Balbi, Maurizio;Ciet, Pierluigi

Writing – Original Draft Preparation

;Chassagnon, Guillaume;Ferrero, Cinzia;Burgel, Pierre-Régis;Sutharsan, Sivagurunathan;Opitz, Marcel;Andrinopoulou, Eleni-Rosalina;Dournes, Gael;Maher, Michael;Duckers, Jamie;Tiddens, Harm;Sermet, Isabelle

2025-01-01

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Abstract

The European Cystic Fibrosis Society-Clinical Trials Network (ECFS-CTN) herein proposes guidance for the use of chest CT-scans for the regular monitoring of lung disease in CF. Statements were completed in a 3-step process: the questions were identified via an anonymous online survey, followed by a comprehensive literature search, and a final Delphi process. The guidance recommends the use of ultra-low dose CT scans (effective radiation dose, 0.08 mSv; equivalent to 2 to 4 chest X-rays), tracking of patients' cumulative radiation and effective communication strategies using “de-medicalized” information for shared decision making. Chest CT scans (with lung volume monitoring) are not recommended systematically in both children and adults. Ultimate responsibility for justifying a chest CT scan lies with the individual professionals directly involved, the final decision being influenced by indications, costs, expertise, available material, resources and/or the patient's values, as well as possible impact on treatment modalities.