Is transthoracic ultrasound (TUS) a reliable predictor of the nature of pleural and peripheral pulmonary lesions? Correlation with cyto-histological findings

Mohamed H Faheem

doi:10.1186/s43055-019-0004-0

Abstract

BackgroundWe focused on determining the most reliable transthoracic ultrasound (TUS) criteria that can predict malignancy of the pleural and peripheral pulmonary lesions and correlating our data with CT and cyto-histological findings. Sixty-nine patients (38 males and 31 females) were enrolled in our prospective study. They were divided into group I (48 patients), which included patients with pleural effusion, and group II (21 patients), which included patients with peripheral pulmonary lesions. All patients underwent chest X-ray (postero-anterior and lateral views), transthoracic ultrasound (TUS), CT chest, guided Tru-cut or surgical biopsies and histopathology, and/or needle aspiration and cytology.ResultsIn group I, the presence of pleural nodularity was a predictor of malignancy with significant statistical difference (b value < 0.001) and receiver operating curve (ROC) curve analysis showed pleural thickening cutoff value of 7 mm at a maximum combined sensitivity and specificity of 75% and 80% respectively and area under the curve 0.825. In group II, distorted intralesional vascular pattern, pleural, and chest wall invasion were statistically significant ultrasonographic malignant predictors (b values are <0.001, 0.016, and 0.004 respectively).ConclusionTUS is a valuable and safe complementary method in differentiation between benign and malignant pleural effusion and peripheral pulmonary lesions but is not a substitute for CT.

Highlights

We focused on determining the most reliable transthoracic ultrasound (TUS) criteria that can predict malignancy of the pleural and peripheral pulmonary lesions and correlating our data with Computed tomography (CT) and cyto-histological findings
The results of the study sample (69 patients) was divided into group I (48 patients) including patients who presented mainly with pleural effusion and group II (21 patients) including patients who presented with peripheral pulmonary lesions
Group I Forty-eight patients were enrolled within the pleural lesion group (20 males “41.7%” and 28 females “58.3%”)

Summary

Introduction

We focused on determining the most reliable transthoracic ultrasound (TUS) criteria that can predict malignancy of the pleural and peripheral pulmonary lesions and correlating our data with CT and cyto-histological findings. Sixty-nine patients (38 males and 31 females) were enrolled in our prospective study. They were divided into group I (48 patients), which included patients with pleural effusion, and group II (21 patients), which included patients with peripheral pulmonary lesions. The peripheral pulmonary and pleural lesions represent an important problem in the pulmonary diagnosis. They can remain undetermined after radiographic and CT scan analysis, so ultrasound can contribute in assessing the nature of these lesions [1]. CT remains the main imaging modality in the diagnosis of the pleural and peripheral pulmonary lesions, Hallifax et al found that the use of TUS is a valuable complementary imaging modality for evaluation of the pleural lesions [5]

Results

Discussion

Conclusion