157 The routine annual review chest X-ray (CXR) in CF – is it useful?

Abstract

Objectives: An Annual Review, including a chest X-ray (CXR), is mandatory for all CF patients to ensure that treatment of their complex disease is optimized. Since the CXR involves potentially harmful ionizing radiation, we assessed the value of its routine use at annual assessment. Methods: We looked at 65 adult CF patients who had undergone a CXR solely as part of their annual review and compared the results with previous radiological and clinical parameters, looking for potential changes in management. Results: The results are summarised in the table. Only 2 (3%) had new findings that altered clinical management: one with new patchy airspace changes and one with bronchial mucus plugging. Both cases were well with no change in symptoms or other objective clinical parameters dictating a modification in treatment. The remaining patients had unchanged CXR appearances, were clinically stable, and did not require any alteration in management. Conclusions: This study illustrates the low yield of significant findings of routine chest radiological imaging in adult CF patients with stable disease, questioning whether this potentially harmful investigation should still be mandated at annual review.