Ultralow Dose Thoracic Computed Tomography in Immunocompromised Patients

Study Overview
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Brief Summary
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Patients with bone marrow cancer are more susceptible to chest infections than healthy adults; marrow ablation treatment further compromises their immune status and increases the risk of fungal opportunistic infection, which is associated with a high fatality rate. Therefore, it is critical to achieve early and accurate diagnosis of fungal infection when these patients become febrile. At the Mount Sinai Hospital (MSH) and the University Health Network (UHN), the standard of care (SOC) to exclude a chest infection in immunocompromised (IC) patients is chest computed tomography (CT) using low dose CT (LDCTT).

Detailed Description
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As patients may have several febrile episodes during their hospital stay, the cumulative dose from LDCTT scans can be significant and increase the lifetime risk of inducing a second cancer. The aim of this project is to determine whether a 75% reduction in radiation dose for LDCTT in other words, an ultralow dose chest CT (uLDCTT) at a dose comparable to chest X-ray, maintains the diagnostic image quality for detection of fungal chest infection in IC patients. If successful, uLDCTT will be adopted as SOC imaging at Princess Margaret Cancer Center (PM) for these patients.

Official Title
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Ultralow Dose Thoracic Computed Tomography in Immunocompromised Patients

Conditions
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Leukemia

Intervention / Treatment
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* Device: Ultralow Dose Thoracic Computed Tomography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All immunocompromised patients clinically referred for LDCTT to the Medical Imaging department at PM 18 years and older Exclusion Criteria: Patients that cannot follow study procedures

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ultralow dose research<br>An Ultralow Dose Thoracic Computed Tomography scan will be added to the standard of care Low dose CT scan. The image quality of the ultralow dose CT will be compared to the Low dose thoracic Computed Tomography. | Device: Ultralow Dose Thoracic Computed Tomography<br>* Ultralow dose chest CT (uLDCTT) at a radiation dose comparable to 2 chest X-rays<br>* Other names: Ultralow dose CT;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Image acquisition | Perform paired clinical low dose (LDCTT) and research ultralow dose (uLDCTT) chest CT in immunocompromised (IC) patients who present with febrile neutropenia (FN) and are clinically referred for LDCTT to exclude opportunistic fungal infection. | Study Day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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bone marrow transplant, infection, computed tomography, radiation dose