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CT Halo sign: A systematic review.

Animesh Ray1, Ankit Mittal2, Surabhi Vyas3

  • 1Department of Medicine, AIIMS, Delhi, 110029, India.

European Journal of Radiology
|February 3, 2020
PubMed
Summary

The CT Halo sign (HS) is a lung opacity seen in various conditions. While specific for invasive fungal infections (IFI) in immunosuppressed patients, it cannot rule out IFI or differentiate between fungal types.

Keywords:
Invasive fungal infectionsInvasive pulmonary aspergillosisMeta-AnalysisSystematic review

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Area of Science:

  • Radiology
  • Pulmonology
  • Infectious Diseases

Background:

  • The CT Halo sign (HS) is a radiographic finding characterized by ground-glass opacity surrounding a lung nodule or mass.
  • Understanding the etiological associations and diagnostic utility of HS is crucial, particularly in immunocompromised individuals.

Purpose of the Study:

  • To systematically review the etiological associations of the CT Halo sign (HS).
  • To evaluate the diagnostic performance of HS for invasive fungal infections (IFI) in immunosuppressed patients.

Main Methods:

  • A systematic review adhering to PRISMA guidelines was conducted.
  • Searched PubMed and EMBASE databases up to June 2018, including case reports, case series, and original English-language articles.
  • 168 studies involving 1977 patients with HS were analyzed, with 14 studies included in quantitative analysis for IFI diagnosis.

Main Results:

  • Invasive fungal infections (IFI) were the most common diagnosis in immunosuppressed patients with HS (86.9%).
  • The pooled sensitivity, specificity, and odds ratio of HS for diagnosing IFI were 50.4%, 91%, and 6.61, respectively.
  • HS could not reliably differentiate between invasive pulmonary aspergillosis (IPA) and mucormycosis.

Conclusions:

  • The CT Halo sign (HS) is associated with diverse conditions in both immunosuppressed and immunocompetent populations.
  • In immunosuppressed patients, HS is specific for IFI but lacks the ability to rule out the infection.
  • HS is not a reliable differentiator between invasive pulmonary aspergillosis and mucormycosis.