Computed tomography as an initial study in suspected CAP

A recently published paper discussed the use of computed tomography (CT) as an initial study in patients presenting with suspected community-acquired pneumonia (CAP). The results were encouraging but not game-changing. In your opinion, when could a clinician consider CT in an outpatient presenting with symptoms of CAP?

Mark Woodhead: I would not rush to making a specific recommendation at the moment. This is one study in one particular population. It is interesting and very promising, but I think first of all it needs to be repeated in other populations to be sure that the results are transferrable to other populations. But also importantly, the end points of the study were related to diagnosis, not to outcomes of the patient. So while it is reasonable to speculate that the outcomes of the patients might have been improved by using the CT scan, we do not know that.

There is a considerable cost to using a CT scan, and there is also a radiation cost to the patient. It needs to be looked into in more detail with regard to outcomes to the patients and with regard to the cost involved and the practicality before one could make a clear recommendation. At this point in time, I would only say that CT is potentially a useful additional tool in the occasional circumstance where you have a patient where you are not sure, where the chest radiograph does not give you a clear answer, then doing a CT scan in addition might give added information.