is it common to get chest CT 6 months after starting big 3 for MAC?

Posted by six5532one @six5532one, Sep 16, 2025

I'm approaching 6 months after starting the big 3 to treat MAC and want to safely and accurately determine the status of my infection. I was diagnosed via bronchoscopy and have never generated a positive sputum sample otherwise. Each month since starting drug therapy, I've submitted a sputum sample. My samples are mostly saliva, even after going to the sputum induction lab. Even if I found a way to submit better quality sputum samples, no one knows whether that sputum came from a part of my lungs that's impacted by MAC.

At the 6 month mark, should I get a low-dose CT scan? Would it be informative after just 6 months? If the past 6 months of drug therapy were effective, would that result in noticeable improvement in nodules and tree-in-bud opacities in that amount of time? Or would a CT that looks the same as the baseline indicate that the drugs are effective, given this time frame? If it's prudent to reschedule the CT for later, when do you recommend I schedule it for and why?

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Rick | @rstel7272 | Sep 17, 2025

Depending on your symptoms and treatment, 3 or 6 months would the norm.

happyhealthyme | @happyhealthyme | Sep 17, 2025

Maybe this could be helpful to you. I had a CT scan taken after 5 1/2 months on the Big 3 for MAI with the results showing what seems to be a reduction in the size of a nodule. I'm copying the relevant lines from the CT scan report here: Interval decreased size of the previously noted waxing and waning right lower lobe nodular bandlike consolidation, the largest thickness of which now measuring 1.1 cm, previously up to 1.9 cm (202:76), likely reflecting chronic mucoid impaction.

six5532one | @six5532one | Sep 17, 2025

In reply to @happyhealthyme "Maybe this could be helpful to you. I had a CT scan taken after 5 1/2..." + (show)

Congratulations, that's great to hear! Thank you for sharing concrete, specific numbers. I scheduled the CT for exactly 5.5 months after starting the meds and was afraid it was too soon to be informative.

Mary | @mjb24 | Sep 18, 2025

I also go every 6 months for a CT. Since we require frequent CT scans, it is recommended to ask for an esophagus shield since the esophagus is one of the most radioactive sensitive organs.

pmmar1 | @pmmar1 | Sep 18, 2025

I am on no meds. I am a patient at NJH and go every 6 months for CT scans, spirometer, sputum sample and consultation with my ID doctor. About every 6 months is the norm depending on symptoms.

terrimn | @terrimn | Sep 23, 2025

I'm on the Big 3 plus Arikayce. Patient at UMN in partner with Mayo Rochester. CT with ID doc every 6 months (esophagus shield is a given at Mayo), sputum testing e/o week, and blood draw every month. Grateful my clinic lab is only 1 mile away, so I walk!

Mary | @mjb24 | Sep 23, 2025

In reply to @terrimn "I'm on the Big 3 plus Arikayce. Patient at UMN in partner with Mayo Rochester. CT..." + (show)

None of my doctors ever mentioned an esophagus shield and I was never offered one. I only found out about it after my last CT when they found nodules on my esophagus. I questioned my pcp about all the CTs my pulmonologist orders and that's when she told me about asking for a shield. Glad you're at Mayo and they're on top of it for you.

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