TY - JOUR T1 - Can chest radiograph(CXR) predict diagnosis and intervention of congenital thoracic malformations? JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.2819 VL - 56 IS - suppl 64 SP - 2819 AU - Laura Price AU - Emily King AU - Elisabeth Parks AU - Rhian Isaac AU - Iolo Doull AU - Julian Forton AU - Lena Thia Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/2819.abstract N2 - Introduction: Congenital thoracic malformations (CTM) can be detected antenatally. There is no universal guidance for asymptomatic lesions although surgical resection has been advocated due to potential complications. Current Welsh guideline for neonates with antenatally detected CTM include CXR after birth with hospital observation for 24 hours. Chest computed tomography(CT) is performed at the Children's Hospital for Wales within the first 3m of age.Aim: To investigate whether initial CXR can predict CTM and subsequent need for surgery.Methods: All infants with chest CT performed under a year of age were identified from 2010-2019 through search criteria for congenital lung lesions. Initial CXR of those with antenatal diagnosis were reviewed together with their clinical records.Results: 67 antenatally detected infants had initial CXR; 23(34%) were normal, 44(66%) were abnormal irrespective of size of lung lesions. 20(87%) with normal CXR had CT confirmed lung lesions of which 9 had elective resection (39% of those with normal CXR). All with abnormal CXR had abnormal CT and 25 required surgery (57% with abnormal CXR) but 10 required emergency resection. Sensitivity, specificity, positive and negative predictive values of CXR confirming CT lung lesions are 69%,100%,100% and 13% respectively whilst CXR as a screening test for surgical resection is poor (74%,42%,56%,61%).Conclusions: Initial CXR is not useful in confirming antenatally detected CTM or surgery. However in the absence of CXR abnormalities, no infants required emergency surgery. This may reassure neonatologists in the safe discharge of neonates until definitive evaluation.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 2819.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -