CDC offers imaging guidance on vaping-related lung injuries

Radiologists take note, the vaping-related lung injuries that have affected people across the U.S. have a new name: EVALI, or e-cigarette or vaping product use-associated lung injury.

The Centers for Disease Control and Prevention (CDC) made the name official, Friday, Oct. 11, in new interim guidance for healthcare providers. The report also provides a framework for clinicians to use in their initial assessment, evaluation, management and follow-up in patients with symptoms of EVALI—including imaging-related advice.

The CDC recommended that clinicians perform a chest x-ray on all patients with a history of e-cigarette or vaping use who have respiratory or gastrointestinal symptoms, especially when oxygen saturation is below 95%. Imaging findings that may indicate EVALI include pulmonary infiltrates on chest x-ray and opacities on chest CT scans.

Physicians should decide whether to perform a chest CT on a case-by-case basis, the CDC recommended. A scan “might” be useful when a chest radiograph doesn’t correlate with clinical findings or to analyze severe disease, complications or other illnesses in the “differential diagnosis.”

To date, the illness has sickened 1,299 people across 49 states, Washington, D.C., and the U.S. Virgin Islands. Radiologists can play a vital role in recognizing the patterns typically seen with EVALI, and may be the first to prompt a care team to consider whether or not a patient may have the condition.

The American Journal of Roentgenology released a study last week, which detailed six distinct patterns radiologists should look for on imaging exams.

The CDC hasn’t been able to pin down a direct cause behind these lung injuries, but still recommended avoiding e-cigarettes or vaping products that use THC.

“At this time, FDA and CDC have not identified the cause or causes of the lung injuries among EVALI cases, and the only commonality among all cases is that patients report the use of e-cigarette, or vaping, products,” the guidance read. “Therefore, CDC recommends that persons should not use e-cigarette, or vaping, products that contain THC.”