Ultrasonic Elastography-guided Pleural Biopsy for the Diagnosis of Pleural Effusion: A Multicenter Prospective Study of Diagnostic Test Performance

Link to article at PubMed

Ann Am Thorac Soc. 2023 Apr 25. doi: 10.1513/AnnalsATS.202212-1047OC. Online ahead of print.


RATIONALE: The diagnostic yields of traditional ultrasound-guided pleural biopsy remain unsatisfactory, especially when the pleural thickness is ≤ 5 mm and/or no pleural nodules are detected. Pleural ultrasound elastography has a better diagnostic yield than traditional ultrasound for malignant pleural effusion. However, studies of ultrasound elastography-guided pleural biopsy are lacking.

OBJECTIVES: To evaluate the feasibility and safety of ultrasound elastography -guided pleural biopsies.

METHODS: In this multicenter prospective single-arm trial, patients with pleural effusion whose pleural thickness ≤ 5 mm and no pleural nodules were enrolledbetween July 2019 and August 2021. Ultrasound elastography-guided pleural biopsy diagnostic yield for pleural effusion and sensitivity for malignant pleural effusion were evaluated.

RESULTS: Ninety-eight patients (mean age, 62.4±13.2 years; 65 men) were prospectively enrolled. The diagnostic yield of ultrasound elastography-guided pleural biopsy for making any diagnosis was 92.9% (91/98), and the sensitivity of ultrasound elastography-guided pleural biopsy for malignant pleural effusion was 88.7% (55/62). In additional, the sensitivity of ultrasound elastography-guided pleural biopsy for pleural tuberculosis was 69.6% (16/23). The rate of postoperative chest pain was acceptable, and there was no pneumothorax in patients.

CONCLUSIONS: Elastography-guided pleural biopsy is a novel technique for diagnosing malignant pleural effusion with a good diagnostic yield and sensitivity. Clinical trial registered at https://www.chictr.org.cn (ChiCTR2000033572).

PMID:37098021 | DOI:10.1513/AnnalsATS.202212-1047OC

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