Diagnostic accuracy and clinical usefulness of lung ultrasound in onco hematological patients with neutropenic fever.

Lung ultrasound (LUS) is a reliable tool for diagnosing pneumonia, a common complication in onco-hematological patients; however, data in this setting are limited. We assessed the diagnostic accuracy and clinical usefulness of LUS performed by trained hematologists in febrile neutropenic patients, compared to chest X-ray (CXR), and using high-resolution computed tomography (HRCT) as reference test. At fever onset, 123 hospitalized neutropenic onco-hematological patients underwent a bedside CXR and LUS. Seventy-one patients underwent HRCT for a positive CXR, persistent fever or respiratory failure, and were included in the analysis. Overall, 39 patients developed pneumonia. Compared to HRCT, LUS and CXR showed a sensitivity of 71.8% and 51.3%, and a specificity of 87.5% and 81.3%, respectively. AUC-ROC was 0.80 for LUS and 0.66 for CXR (p = 0.04). Net reclassification index (NRI) of LUS was 20.5% for pneumonia, and 6.3% for no pneumonia cases. LUS showed high diagnostic accuracy for pneumonia in this setting.