Image: Dr. James Tsung, MD, showcases a lung ultrasound display on a tablet (Photo courtesy of Mount Sinai Hospital).
The results of a randomized controlled trial in the pediatric emergency department of a leading medical school in the US suggest that lung ultrasound is highly effective, and safe, for diagnosing pneumonia in children, and could potentially be used as a substitute for standard chest X-Ray exams.
According to the World Health Organization (WHO) pneumonia is the leading cause of death in children worldwide. While chest X-Rays exams are currently the standard choice for diagnosis, the WHO estimates that 75% of the world’s population does not have access to radiography.
The results of the study were published in the March, 2016 issue of the journal Chest. The study included 191 children aged 0 to 21 years. The children were randomly assigned to receive either a lung ultrasound and if necessary also a chest X-ray, and a control group that underwent a chest X-ray followed by a lung ultrasound. The study was conducted by researchers at the Mount Sinai hospital Icahn School of Medicine (ISMMS; New York, NK, USA).
The researchers found that 38.8% less chest X-Rays were performed in the group that underwent an initial ultrasound exam, compared to no reduction in the control group. No pneumonia cases were missed and there was no increase in any other adverse events. The replacement of X-Ray exams by ultrasound resulted in overall cost savings of USD 9,200, and reduced the time the children spent in the emergency ward by an average of 26 minutes. The results suggest that lung ultrasound could become the best option for the diagnosis of pneumonia in children, although further research is required.
Dr. Tsung, associate professor at Mount Sinai, and leader of the research team, said, “Ultrasound is portable, cost-saving and safer for children than an X-ray because it does not expose them to radiation. Our study could have a profound impact in the developing world where access to radiography is limited. 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.
Mount Sinai hospital Icahn School of Medicine