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The diagnostic value of transthoracic ultrasonographic features in predicting malignancy in undiagnosed pleural effusions

2014-01-30Artigo científico Acesso aberto
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dc.contributor.authorBugalho, Antonio
dc.contributor.authorFerreira, Dalila
dc.contributor.authorDias, Sara S.
dc.contributor.authorSchuhmann, Maren
dc.contributor.authorBranco, Jose C.
dc.contributor.authorMarques Gomes, Maria J.
dc.contributor.authorEberhardt, Ralf
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionCentro de Estudos de Doenças Crónicas (CEDOC)
dc.contributor.pblS. Karger AG
dc.date.accessioned2024-02-21T22:19:34Z
dc.date.available2024-02-21T22:19:34Z
dc.date.issued2014-01-30
dc.description.abstractBackground: Transthoracic ultrasound (US) is an important instrument to identify pleural effusions and safely conduct invasive procedures. It also allows systematic scanning of the pleural surface, though its value remains uncertain for differentiation between malignant (MPE) and nonmalignant pleural effusion (non-MPE) in routine clinical practice. Objectives: To evaluate the utility of US features to predict malignancy in undiagnosed pleural effusions in a real-life clinical setting. Methods: The US features of 154 consecutive patients with a pleural effusion were prospectively assessed. Anonymous images were recorded by an operator blinded to the clinical and radiological results. The US findings were classified by independent reviewers and compared to the final diagnosis. Results: A total of 133 patients were included (age 67 ± 16 years; BMI 25.1 ± 4.6; 54.1% females). The final diagnosis was MPE in 66 cases and non-MPE in 67 cases. US had an overall sensitivity of 80.3%, a specificity of 83.6%, and positive and negative predictive values of 82.8 and 81.2%, respectively, for the detection of malignancy. US accuracy was 81.9%. The presence of pleural/diaphragmatic nodules, pleural/diaphragmatic thickness >10 mm, and a swirling sign was significantly different between both groups (p < 0.001). Lung air bronchogram sign and a septated US pattern were more common in non-MPE patients (p < 0.01). The existence of nodularity and the absence of air bronchograms were more likely to indicate malignancy (OR 29.0, 95% CI 7.65-110.08 and OR 10.4, 95% CI 1.65-65.752, respectively). Conclusions: In the presence of an undiagnosed pleural effusion, US morphological characteristics can aid in differentiating MPE from non-MPE. Pleural/diaphragmatic nodularity was the most relevant feature although no finding was pathognomonic of MPE.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent9
dc.format.extent631585
dc.identifier.doi10.1159/000357266
dc.identifier.issn0025-7931
dc.identifier.otherPURE: 4449182
dc.identifier.otherPURE UUID: f29b991f-ecbb-4466-9d7a-0b7f32fef940
dc.identifier.otherScopus: 84898597883
dc.identifier.otherPubMed: 24480900
dc.identifier.otherWOS: 000334297300003
dc.identifier.urihttp://hdl.handle.net/10362/163892
dc.identifier.urlhttps://www.scopus.com/pages/publications/84898597883
dc.language.isoeng
dc.peerreviewedyes
dc.subjectDiagnosis
dc.subjectLung cancer
dc.subjectNeoplasia
dc.subjectPleural effusion
dc.subjectThorax
dc.subjectUltrasound
dc.subjectPulmonary and Respiratory Medicine
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleThe diagnostic value of transthoracic ultrasonographic features in predicting malignancy in undiagnosed pleural effusionsen
dc.title.subtitleA prospective observational studyen
dc.typejournal article
degois.publication.firstPage270
degois.publication.issue4
degois.publication.lastPage278
degois.publication.titleRespiration
degois.publication.volume87
dspace.entity.typePublication
rcaap.rightsopenAccess

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