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Updated: Jan 9, 2026
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Diagnostic accuracy of various imaging modalities for children with pneumonia: a systematic review and network
Feiyang Na1,2,3, Yannan Wang2,3, Chen Tian4
1Department of Pediatric, Gansu Provincial Maternity and Child Care Hospital (Gansu Province Central Hospital), Lanzhou, China.
Insights
Computer-aided chest radiography and lung ultrasound show high diagnostic accuracy for childhood pneumonia. These imaging techniques offer valuable clinical utility, though further research is needed for other computer-aided modalities.
Area of Science:
- Medical Imaging
- Pediatric Pulmonology
- Diagnostic Accuracy
Background:
- Pneumonia is a leading cause of death and illness in children worldwide.
- Current imaging methods for diagnosing pediatric pneumonia have inadequately characterized accuracy.
- There is a need for systematic evaluation of diagnostic tools.
Purpose of the Study:
- To systematically evaluate and compare the diagnostic accuracy of imaging modalities for pediatric pneumonia.
- To conduct diagnostic test accuracy (DTA) meta-analyses and network meta-analyses (NMA).
Main Methods:
- Searched PubMed, Embase, Cochrane Library, and Web of Science up to March 2025.
- Assessed risk of bias using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2).
- Pooled diagnostic accuracy using random-effects DTA meta-analyses and compared performance using NMAs.
Main Results:
- Included 81 studies (34,625 children) from 22 countries.
- Lung ultrasound showed high accuracy (sensitivity 0.91, specificity 0.93) against clinical examination.
- Computer-aided chest radiography demonstrated superior overall diagnostic performance compared to lung ultrasound, except for specificity.
Conclusions:
- Computer-aided chest radiography and lung ultrasound are clinically useful for diagnosing pediatric pneumonia.
- Insufficient evidence exists for other computer-aided modalities.
- High-quality comparative studies are required to validate findings and assess new technologies.
Background:
Pneumonia remains the predominant cause of childhood mortality and morbidity globally. While various imaging modalities have been employed for paediatric pneumonia diagnosis, the diagnostic accuracy remains inadequately characterised.
Objective:
To systematically evaluate and compare the diagnostic accuracy of available imaging modalities for paediatric pneumonia through both diagnostic test accuracy (DTA) meta-analyses and network meta-analysis (NMA).
Methods:
PubMed, Embase, Cochrane Library and Web of Science were searched up to March 2025. The risk of bias was graded using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Diagnostic accuracy measures were pooled using random-effects DTA meta-analyses, while relative diagnostic performance was compared through NMAs.
Results:
81 studies published in 22 countries since 2008 were included, with a total of 34 625 children. In most of the studies, there was an unclear risk of bias. When clinical examination served as reference test, lung ultrasound demonstrated high diagnostic accuracy with sensitivity of 0.91 and specificity of 0.93. NMAs showed superior overall diagnostic performance of computer-aided chest radiography compared to lung ultrasound across all indexes except specificity, where there was no difference in sensitivity or specificity between the two. Meta-regression identified study design and pneumonia type as significant modifiers of diagnostic sensitivity.
Conclusion:
This comprehensive analysis provides robust evidence supporting the clinical utility of computer-aided chest radiography and lung ultrasound for paediatric pneumonia diagnosis. However, insufficient evidence precludes definitive conclusions regarding other computer-aided modalities. Future high-quality comparative studies are needed to validate these findings in diverse clinical settings and evaluate emerging imaging technologies.
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