NCT04978116: OCTOPLUS

CT Scan Compared to CXR and LUS in Pneumonia in the Elderly

Completed NA Last updated 29 January 2026

What this trial tests

NA trial testing Chest X-Ray (CXR) in Pneumonia in 473 participants. Completed in 1 July 2025.

Timeline

17 June 2021

Primary endpoint
3 May 2025

1 July 2025

Quick facts

Lead sponsor	University Hospital, Geneva
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	single
Primary purpose	diagnostic
Enrollment	473
Start date	17 June 2021
Primary completion	3 May 2025
Estimated completion	1 July 2025
Sites	3 locations across Switzerland

Drugs / interventions tested

• Chest X-Ray (CXR)
• Low-dose CT scan (LDCT)
• Lung ultrasonography (LUS)

Conditions studied

• Pneumonia — all drugs for Pneumonia →
• Elderly Infection — all drugs for Elderly Infection →

Sponsor

University Hospital, Geneva

Who can join

65 and older, any sex, with Pneumonia or Elderly Infection. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Introduction: Pneumonia is a leading cause of mortality and a common indication for antibiotic in elderly patients. However, its diagnosis is often inaccurate. The investigators aim to compare the diagnostic accuracy, the clinical and cost outcomes and the use of antibiotics associated with three imaging strategies in patients \>65 years old with suspected pneumonia in the emergency room (ER): Chest-X ray (CXR, standard of care), low-dose CT scan (LDCT) or lung US (LUS).

Methods and analysis: This is a multicenter randomized superiority clinical trial with three parallel arms. Patients will be allocated in the ER to a diagnostic strategy based on either CXR, LDCT, or LUS. All three imaging modalities will be performed but the results of two of them will be masked during 5 days to the patients, the physicians in charge of the patients and the investigators according to random allocation. The primary objective is to compare the accuracy of LDCT vs CXR- based strategies. As secondary objectives, antibiotics prescription, clinical and cost outcomes will be compared, and the same analyses repeated to compare the LUS and CXR strategies. The reference diagnosis will be established a posteriori by a panel of experts. Based on a previous study, the investigatory expect an improvement of 16% of the accuracy of pneumonia diagnosis using LDCT instead of CXR. Under this assumption, and accounting for 10% of drop out, the enrolment of 495 patients is needed to prove the superiority of LDCT over CRX (alpha error =0.05, beta error=0.10).

Impact of the study: Superiority of the LDCT or LUS strategy over CXR would affect recommendations for the diagnosis of pneumonia in elderly patients. A higher accuracy of one of the strategies may decrease antibiotics overuse and lead to better outcomes and reduced costs.

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

1. LOw-dose CT Or Lung UltraSonography versus standard of care based-strategies for the diagnosis of pneumonia in the elderly: protocol for a multicentre randomised controlled trial (OCTOPLUS).
   Prendki V, Garin N, Stirnemann J, Combescure C, et al · · 2022 · cited 5× · PMID 35523502 · DOI 10.1136/bmjopen-2021-055869
2. Protocol for a multicentric, double-blind, randomised controlled trial of hyperbaric oxygen therapy (HBOT) versus sham for treating vaso-occlusive crisis (VOC) in sickle cell disease (SCD) in patients aged 8 years or older (HBOT-SCD study).
   Stirnemann J, Serratrice J, Mann T, Louge P, et al · · 2024 · cited 1× · PMID 39613437 · DOI 10.1136/bmjopen-2024-084825
3. European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global 2026.
   Becker S. · · 2026 · PMID 42109293 · DOI 10.1016/j.lanepe.2026.101706