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British Journal of Radiology (2003) 76, 213
© 2003 British Institute of Radiology
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Correspondence

Authors' reply

The Editor—Sir,

Dr Henderson's letter confirms the variation in practice noted in our paper. Often this variation is not supported by evidence.

As stated in the paper, Perlmutt et al [1] noted that 89% of pneumothoraces were detected immediately and a further 9% at 1 h. More importantly, of those requiring intervention, 88% were detected immediately, leaving 12%, which became evident at 1 h. This latter group is a significant proportion of the total. These figures have been confirmed in our own practice audit.

Dr Henderson keeps the patients in the ward for 4 h following biopsy. In many centres this puts an unnecessary pressure on beds when patients can be observed in a much more informal manner for 1 h and their subsequent management then determined. We agree that discharge must take into account the patient's home circumstances.

Henderson also raises the question of radiation dose. The dose of a single CT slice will vary according to the scanning parameters. We estimate that the dose of a single 10 mm slice is approximately 150 µSv and the effective dose of a single chest radiograph is about 10 µSv.

Our reasons for suggesting a 1 h film therefore are that it detects all significant pneumothoraces requiring intervention, makes better use of ward resources and has a lower radiation dose to the patient.

Yours etc.,

C M Richardson, K S Pointon, A R Manhire and J T MacFarlane

1 Department of Respiratory Medicine, Medical Research Centre Building and 2 Department of Radiology, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK

Received for publication November 14, 2002. Accepted for publication November 28, 2002.

References

  1. Perlmutt LM, Braun SD, Neuman GE, Oke EJ, Dunnick NR. Timing of chest film follow-up after transthoracic needle aspiration. AJR 1986;146:1049–50.[Abstract/Free Full Text]

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Percutaneous lung biopsies
R Henderson
BJR 2003 76: 213. [Full Text]  




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