Comparative Study of Low-Dose Ct Vs Conventional Radiography for Pulmonary Complications in Sickle Cell Anemia

Abstract

Background: Sickle cell anemia (SCA) is associated with frequent pulmonary complications such as acute chest syndrome, pneumonia, pulmonary embolism, and chronic lung changes. Conventional chest radiography (CXR) is widely used but often underestimates disease burden. Low-dose CT (LDCT) has emerged as a potential alternative, offering higher diagnostic accuracy at reduced radiation exposure compared to conventional CT.

Objectives:To compare the diagnostic yield, radiation exposure, and overall performance of low-dose CT versus conventional chest radiography in evaluating pulmonary complications in patients with SCA.

Methods:This prospective comparative study included 120 patients with confirmed SCA presenting with acute respiratory symptoms. All participants underwent chest radiography followed by LDCT. Imaging findings were evaluated independently by two blinded radiologists. Diagnostic accuracy was calculated against a composite clinical and laboratory reference standard. Radiation dose parameters were also recorded. Statistical analysis was performed using SPSS v25, with p <0.05 considered significant.

Results:LDCT detected more cases of consolidation (70% vs 51.7%), ground-glass opacities (38.3% vs 10%), pulmonary embolism (8.3% vs 1.7%), and atelectasis (18.3% vs 6.7%) compared to CXR (p <0.05). Overall sensitivity, specificity, and accuracy of LDCT were 91.7%, 88.3%, and 90%, respectively, versus 68.3%, 75%, and 71.7% for CXR. Mean radiation dose was 1.4 mSv for LDCT compared to 0.08 mSv for CXR, and 6.5 mSv for standard CT.

Conclusion:LDCT provided significantly higher diagnostic accuracy than conventional radiography, with acceptable radiation exposure. It should be considered as a frontline imaging modality in suspected pulmonary complications of SCA, particularly when CXR is inconclusive.