254 The value of the routine annual review chest radiograph in adults with CF

Abstract

Objectives The UK CF Trust Standards of care recommend that all adults undergo a chest X-ray (CXR) at annual review; to assess clinical progression and complications. However, the value of CXR in assessing disease progression in CF is debated, with some recommending they are replaced by CT scans (Tiddens et al. 2014). We wished to assess the clinical impact of the routine CXR at annual review. Methods We identified 83 (43%) patients of our total CF cohort (n = 196) who underwent CXR solely as part of their annual review. Radiographs were compared with previous studies and any changes in clinical management resulting from them identified. Results The average age was 30±9 yrs, with a mean FEV 1 79±22%. 69% were male and 31% female. 36% had CF related diabetes. 57% were colonized with Pseudomonas, 7% with B. cepacia and 7% with M. abscessus. Mean oral and intravenous antibiotic days in the preceding year were 14±19 and 16±25 respectively. Of the 83 patients, 15 (18%) had new findings, 8 of whom (53%) went on to have a thoracic CT scan. 14 (17%) needed a change in clinical management. The remaining 68 patients had unchanged CXR appearances, were clinically stable, and required no alteration in management. Conclusions As life expectancy increases annual surveillance of stable patients is an increasingly important part of CF care. We found that screening CXRs identified changes in