Limited clinical utility of annual chest radiographs in adults with cystic fibrosis: A 10-year observational study from a UK centre.

BACKGROUND

In the United Kingdom, annual chest radiography is recommended to monitor disease progression in people with cystic fibrosis (CF), yet robust evidence for its utility or relationship with clinical outcomes is lacking. This study explores disease progression on serial chest radiographs, together with relationships of other markers of disease severity.

METHOD: Single centre, retrospective analysis of annual chest radiographs in adults with CF across ≥10 years. A novel chest x-ray (CXR) scoring system was developed, and annual chest radiographs scored, along with time-matched spirometry and body mass index.

RESULTS

28 patients, aged 33.0 (31.0-39.5) years were included. Mean follow-ups were 11.4 (SD = 1.9) years with a total of 304 CXR scored (mean = 10.9/person). Overall inter-observer agreement was good. No significant or only weak associations were found between changes in total CXR score, or individual CXR variables, and changes in any clinical parameter.

CONCLUSIONS

Our new and practical CXR score shows annual changes in CXR in adults with CF are insufficiently sensitive to detect disease progression and show no relationship to changes in other clinical parameters. These data suggest limited value in routine annual CXR for stable adults with CF.