Chest Radiography in Tuberculosis Detection – Summary of Current WHO Recommendations and Guidance on Programmatic Approaches

Chest radiography, or chest X-ray (CXR), is an important tool for triaging and screening for pulmonary TB, and it is also useful to aid diagnosis when pulmonary TB cannot be confirmed bacteriologically. Although recent diagnostic strategies have given specific prominence to bacteriology, CXR can be used for selecting individuals for referral for bacteriological examination, and the role of radiology remains important when bacteriological tests cannot provide a clear answer. Access to high-quality radiography is limited in many settings. Ensuring the wider and quality-assured use of CXR for TB detection in combination with laboratory-based diagnostic tests recommended by the World Health Organization (WHO), can contribute to earlier TB diagnosis and potentially to closing the TB case-detection gap when used as part of algorithms within a framework of health-system and laboratory strengthening. 

This document summarizes WHO’s recommendations on using CXR for TB triaging, diagnosis and screening. It also outlines a framework for the strategic planning and use of CXR within national TB programmes (NTP). Moreover, the document provides a brief overview of technical specifications, and quality assurance and safety considerations for CXR.