Subash Shanthakumar Heraganahally1,2,3, Timothy P Howarth3,4, Lisa Sorger5,6,7,8. 1. Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia. 2. Flinders University - College of Medicine and Public Health, Adelaide, South Australia, Australia. 3. Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia. 4. College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia. 5. Department of Medical Imaging, Royal Darwin Hospital, Darwin, Northern Territory, Australia. 6. Apex Radiology, Bunbury, Western Australia, Australia. 7. Imaging Services Strategy, Western Australian Country Health Service, Perth, Western Australia, Australia. 8. Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia.
Abstract
INTRODUCTION: There is sparse evidence in the literature in relation to the chest computed tomography (CT) findings among adult Indigenous Australians with chronic respiratory conditions. METHODS: In this retrospective study, patients who underwent chest CT between 2012 and 2020 among those referred to undergo lung function tests (spirometry) were assessed for the prevalence of abnormal chest CT radiological findings. RESULTS: Of the 402 patients (59% female) included in this study, 331 (82%) had an abnormality identified on chest CT. Most abnormalities occurred alongside one (25%) or multiple (46%) other CT abnormalities. Airway disease ((AD) (including, emphysema, airway wall thickening and small airway disease) (35%), atelectasis: segmental or lobar collapse (27%), inflammatory opacities (24%) and bronchiectasis (23%) were the most common findings. AD and bronchiectasis were also the most common concurrent abnormalities in 40-50%. Other CT abnormalities noted in isolation or in combination with other CT findings were lung nodules (19%), lymph node enlargement (17%), consolidation or mass (17%), followed by lung cysts, ground-glass opacity, lung parenchymal architectural distortion, cavitating lung lesions and chronic pleural effusion were observed in ≤10%. Predictive models for odds of abnormality and outcomes showed age, smoking and underweight were associated with AD, and male sex and very remote residence were associated with bronchiectasis. CONCLUSION: This study has illustrated that Indigenous Australian adults have a high prevalence of multiple chest CT abnormalities that may impose unprecedented diagnostic and therapeutic challenges in this population. Further studies are warranted to determine the long-term implications and prognostic significance of the CT findings as demonstrated in this study.
INTRODUCTION: There is sparse evidence in the literature in relation to the chest computed tomography (CT) findings among adult Indigenous Australians with chronic respiratory conditions. METHODS: In this retrospective study, patients who underwent chest CT between 2012 and 2020 among those referred to undergo lung function tests (spirometry) were assessed for the prevalence of abnormal chest CT radiological findings. RESULTS: Of the 402 patients (59% female) included in this study, 331 (82%) had an abnormality identified on chest CT. Most abnormalities occurred alongside one (25%) or multiple (46%) other CT abnormalities. Airway disease ((AD) (including, emphysema, airway wall thickening and small airway disease) (35%), atelectasis: segmental or lobar collapse (27%), inflammatory opacities (24%) and bronchiectasis (23%) were the most common findings. AD and bronchiectasis were also the most common concurrent abnormalities in 40-50%. Other CT abnormalities noted in isolation or in combination with other CT findings were lung nodules (19%), lymph node enlargement (17%), consolidation or mass (17%), followed by lung cysts, ground-glass opacity, lung parenchymal architectural distortion, cavitating lung lesions and chronic pleural effusion were observed in ≤10%. Predictive models for odds of abnormality and outcomes showed age, smoking and underweight were associated with AD, and male sex and very remote residence were associated with bronchiectasis. CONCLUSION: This study has illustrated that Indigenous Australian adults have a high prevalence of multiple chest CT abnormalities that may impose unprecedented diagnostic and therapeutic challenges in this population. Further studies are warranted to determine the long-term implications and prognostic significance of the CT findings as demonstrated in this study.
Authors: Dorothy F L Sze; Timothy P Howarth; Clair D Lake; Helmi Ben Saad; Subash S Heraganahally Journal: Int J Chron Obstruct Pulmon Dis Date: 2022-04-21
Authors: Arijeet Pal; Timothy P Howarth; Chris Rissel; Raelene Messenger; Siji Issac; Linda Ford; Christine Connors; Subash Heraganahally Journal: BMJ Open Respir Res Date: 2022-08