Photo Credit: Paul Biris

The following is a summary of “Guidance for chest-CT in children and adults with cystic fibrosis: A European perspective,” published in the May 2025 issue of the Respiratory Medicine by Fayon et al.

The European Cystic Fibrosis Society-Clinical Trials Network (ECFS-CTN) has developed comprehensive guidance regarding the routine use of chest CT scans for monitoring lung disease progression in individuals with cystic fibrosis. This set of recommendations was established through a rigorous three-step process: initial identification of key clinical questions via an anonymous online survey, an extensive review of the current scientific literature, and consensus-building through a structured Delphi methodology.

The resulting guidance emphasizes the preferential use of ultra-low dose chest CT protocols, with an effective radiation dose approximating 0.08 millisieverts, equivalent to the exposure from two to four standard chest radiographs. In addition, the guidance strongly advocates for the systematic tracking of patients’ cumulative radiation exposure over time to ensure long-term safety. Recognizing the importance of patient engagement, the recommendations highlight the need for clear and accessible communication strategies, suggesting the use of “de-medicalized” language to facilitate shared decision-making processes between healthcare providers and patients.

Importantly, the guidance advises against the routine use of chest CT scans—including those performed with lung volume monitoring—for all children and adults with CF. Instead, imaging decisions should be made judiciously, with careful consideration of individual clinical circumstances. Responsibility for justifying the need for a chest CT scan ultimately lies with the treating professionals directly involved in patient care. Decisions should be guided by specific clinical indications, anticipated impact on treatment strategy, resource availability, local expertise, cost considerations, and, critically, the values and preferences of the patient.

By promoting a patient-centred, evidence-based approach to imaging, this guidance seeks to optimize the use of chest CT in CF care, balancing the benefits of detailed lung assessment against the potential risks associated with cumulative radiation exposure.

Source: resmedjournal.com/article/S0954-6111(25)00138-6/fulltext