Abstract
Introduction Traditional thoracic ultrasound (TUS) is often the initial tool used to help diagnose malignant pleural effusion (MPE). Ultrasound elastography (UE), a relatively new technique, has been used to differentiate malignant disease from benign disease by evaluating tissue “stiffness”. However, no studies evaluating the efficacy of UE for diagnosing MPE are available. We assessed the value of UE for diagnosing MPE prospectively.
Methods All 244 enrolled patients were divided into a development set and a validation set in chronological order. The cut-off elasticity index (EI) was established using a receiver operating characteristic curve constructed from the continuous data of the patients in the development set. The diagnostic performance of UE was compared with that of TUS in the validation set.
Results In the development set, the mean EI (47.25 kPa) was the optimal cut-off. In the validation set, pleural UE had a sensitivity of 83.64%, a specificity of 90.67%, a positive predictive value of 86.79%, a negative predictive value of 88.31%, a positive likelihood ratio of 8.96, and a negative likelihood ratio of 0.18 for diagnosing MPE. The sensitivity of UE was significantly higher (p=0.006) than that of TUS (60.00%).
Conclusion Pleural UE is a better technique than TUS for differentiating MPE from benign pleural disease.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Jiang has nothing to disclose.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Yin has nothing to disclose.
Conflict of interest: Dr. Zhang has nothing to disclose.
Conflict of interest: Dr. Zang has nothing to disclose.
Conflict of interest: Dr. Song has nothing to disclose.
Conflict of interest: Dr. Wang has nothing to disclose.
Conflict of interest: Dr. Kang has nothing to disclose.
Conflict of interest: Dr. Herth has nothing to disclose.
Conflict of interest: Dr. Hou has nothing to disclose.
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