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

• DOI: 10.1513/annalsats.202212-1047oc
• Publication Date: 2023-04-25T17:28:33Z
• Authors: Mingming Deng; Xianwei Ye; Jiangwei Ma; Yang Xia; Qin Zhang; Bin Jiang; Jie Wu; Qing Wen; Yujin Zheng; Yan Yin; Run Tong; Guowu Zhou; Hongmei Yao; Xuelian Li; Felix J. F. Herth; Gang Hou; Chen Wang
• Keywords: Male; Pleural Effusion; Image-Guided Biopsy; Diagnostic Tests, Routine; Humans; Elasticity Imaging Techniques; Ultrasonics; Prospective Studies; Middle Aged; Aged; Pleural Effusion, Malignant

Rationale: The diagnostic yield of traditional ultrasound-guided pleural biopsy remains unsatisfactory, particularly when the pleural thickness is ⩽5 mm and/or no pleural nodules are detected. Pleural ultrasound elastography (UE) has a better diagnostic yield than traditional ultrasound for malignant pleural effusion (MPE). However, studies on UE-guided pleural biopsies are lacking. Objectives: To evaluate the feasibility and safety of UE-guided pleural biopsy. Methods: In this multicenter prospective single-arm trial, patients with pleural effusion whose pleural thickness was ⩽5 mm with no pleural nodules were enrolled between July 2019 and August 2021. The diagnostic yield of UE-guided pleural biopsy for pleural effusion and its sensitivity for detecting MPE were evaluated. Results: Ninety-eight patients (mean age, 62.4 ± 13.2 yr; 65 men) were prospectively enrolled. The diagnostic yield of UE-guided pleural biopsy for making any diagnosis was 92.9% (91/98), and its sensitivity for MPE was 88.7% (55/62). In addition, its sensitivity for pleural tuberculosis was 69.6% (16/23). The rate of postoperative chest pain was acceptable, and there was no pneumothorax. Conclusions: UE-guided pleural biopsy is a novel technique for diagnosing MPE with good diagnostic yield and sensitivity. Clinical trial registered with https://www.chictr.org.cn (ChiCTR2000033572).