Rapid lung MRI - paradigm shift in evaluation of febrile neutropenia in children with leukemia: a pilot study

Leuk Lymphoma. 2016;57(1):70-5. doi: 10.3109/10428194.2015.1041389.

Abstract

Immunocompromised children with hematological malignancies are at increased risk of developing potentially fatal pulmonary infections. Early detection and prompt treatment is critical to combat morbidity and mortality in these children. Twenty-six children with leukemia (age range: 5-13years) presenting with fever and neutropenia were included in this prospective study, which was approved by the institutional ethics committee. All patients underwent HRCT and MRI of the chest on the same day. The findings of HRCT and MRI were compared, with HRCT as the standard of reference. There was perfect agreement between MRI and CT examinations findings by kappa test (κ = 1). No significant difference was observed between the two modalities by the McNemar test (p > 0.05). Rapid lung MRI is technically feasible; has a high correlation, sensitivity and specificity to CT scan; and can emerge as the first line modality for the detection of pulmonary nodules in children with leukemia and persistent febrile neutropenia.

Keywords: CT scan; MRI; Pediatrics; imaging; leukemia; lung.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Febrile Neutropenia / diagnosis*
  • Febrile Neutropenia / etiology*
  • Female
  • Humans
  • Leukemia / complications*
  • Lung / pathology*
  • Magnetic Resonance Imaging*
  • Male
  • Reproducibility of Results
  • Solitary Pulmonary Nodule / pathology
  • Tomography, X-Ray Computed