Purpose or Case Report: As the regional referral centre for paediatric tuberculosis (TB) in Northwest England, we conducted a retrospective review of referrals to assess indications for CT imaging based on clinical presentation and chest X-ray (CXR) findings. A literature review was performed addressing latent TB detection, radiographic features in infants, the WHO End TB strategy, and NICE guidelines.
CXR sensitivity for latent TB detection is as low as 15%, whereas CT imaging, despite higher radiation exposure, offers superior diagnostic accuracy. Guidelines recommend contrast-enhanced CT when CXR findings are inconclusive or diagnostic uncertainty exists.
Our multicentre review identified CT indications including equivocal or abnormal CXRs, extrapulmonary lymphadenopathy, and suspected airway compression. Integral to our protocol is a region-wide multidisciplinary team (MDT) comprising paediatricians, radiologists, infectious disease, and respiratory specialists. The MDT convenes weekly to integrate clinical and radiological data, guiding imaging decisions and management.
This collaborative approach ensures tailored, low-dose CT protocols with expedited reporting, enhancing diagnostic confidence and patient outcomes. The MDT also facilitates consideration of differential diagnoses, including malignancy and steroid effects.
Our findings highlight the critical role of coordinated MDT discussion and protocol adherence in optimizing imaging strategies and improving paediatric TB care.
Methods & Materials:
Results:
Conclusions: