October 13, 2023

BMI and Chest Imaging Accuracy

A recent medical imaging study has produced some surprising results that challenge conventional wisdom. The researchers evaluated 50 patients who underwent both chest x-rays and CT scans. They compared the imaging findings to the final clinical diagnosis in each patient. Unexpectedly, the study found no correlation between a patient’s body mass index (BMI) and the diagnostic accuracy of either modality. Furthermore, accounting for BMI did not improve the concordance between x-ray and CT findings.

This contradicts a natural assumption that larger body sizes negatively impact medical image quality, which, in many cases, it does. However, these findings suggest a patient’s BMI should not be the deciding factor in whether they undergo an x-ray, CT scan, or both. The findings also imply that current protocols automatically boosting radiation exposure for larger patients may be oversimplified. Rather than BMI, the distribution of body fat may be more important in determining ideal radiation levels. Rethinking these protocols could potentially maintain diagnostic accuracy while further reducing radiation exposure to patients. As medical imaging usage increases, it is vital to continually reassess techniques to ensure both efficacy and safety. It will be interesting to see if these findings are replicated in subsequent studies, as they could truly change established best practices.

Citation: Heston TF, Jiang JY. Concordance of chest x-ray with chest CT by body mass index. PeerJ. 2023 Mar 16;11:e15090. doi: https://doi.org/10.7717/peerj.15090