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Diagnosing pneumothorax through standardized bilateral ultrasound images comparison

Guido Levi, Riccardo Maria Inciardi, Manuela Ciarfaglia, Jordan Franz Giordani, Laura Pini, Claudio Tantucci, Chiara Rocchetti, Giampietro Marchetti
European Respiratory Journal 2021 58: PA3540; DOI: 10.1183/13993003.congress-2021.PA3540
Guido Levi
1Interventional Pulmonology Unit & Department of Clinical and Experimental Sciences, Università degli Studi di Brescia & ASST Spedali Civili, Brescia, Italy
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  • For correspondence: guido.levi@yahoo.it
Riccardo Maria Inciardi
2Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Università degli Studi di Brescia, Brescia, Italy
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Manuela Ciarfaglia
3Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy
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Jordan Franz Giordani
3Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy
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Laura Pini
4Respiratory Medicine Unit & Department of Clinical and Experimental Sciences, Università degli Studi di Brescia & ASST Spedali Civili, Brescia, Italy
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Claudio Tantucci
4Respiratory Medicine Unit & Department of Clinical and Experimental Sciences, Università degli Studi di Brescia & ASST Spedali Civili, Brescia, Italy
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Chiara Rocchetti
3Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy
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Giampietro Marchetti
5Pulmonology Unit, ASST Spedali Civili, Brescia, Italy
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Abstract

Introduction: Diagnosing pneumothorax (PTX) is often compared with a potentially poor prognosis, leading clinicians to find new ultrasound (US) signs to obtain a more confident diagnosis.

Aims and objectives: To assess the diagnostic yield of a potential new US sign for PTX diagnosis.

Methods: We designed a prospective case-control study; patients were evaluated with chest US in supine position, collecting a double-view image with two frames: one from the left lung and one from the right lung. An objective analysis, relying on an image-editing program, compared selected areas of 100-pixel width on both sides, whereas a subjective one included 10 different physicians, divided into 5 groups (4 blinded), answering whether the two sides differed by greyscale and/or horizontal artifacts.

Results: 60 patients were enrolled (30 cases). The objective analysis showed a significant difference between the PTX side and the contralateral one, as opposed to the control group. We focused on the ROC curves with the higher area under curve (AUC). The combination of mean ratio (AUC 0.98), range ratio (AUC 0.89) and median ratio (AUC 0.95) resulted in a perfect curve (AUC=1.0). No significant differences were observed among the 5 different groups of physicians.

Conclusions: Our results suggest this may be a potential new tool for diagnosing PTX; it could lead to new US software development, allowing physicians to obtain a much more confident diagnosis.

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Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3540.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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Diagnosing pneumothorax through standardized bilateral ultrasound images comparison
Guido Levi, Riccardo Maria Inciardi, Manuela Ciarfaglia, Jordan Franz Giordani, Laura Pini, Claudio Tantucci, Chiara Rocchetti, Giampietro Marchetti
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3540; DOI: 10.1183/13993003.congress-2021.PA3540

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Diagnosing pneumothorax through standardized bilateral ultrasound images comparison
Guido Levi, Riccardo Maria Inciardi, Manuela Ciarfaglia, Jordan Franz Giordani, Laura Pini, Claudio Tantucci, Chiara Rocchetti, Giampietro Marchetti
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3540; DOI: 10.1183/13993003.congress-2021.PA3540
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