Image-Guided Pleural Biopsy: Issue of the Expertise and Availability of the Resources

Kuwal, Ashok; Dutt, Naveen; Chauhan, Nishant Kumar

doi:10.1159/000446443

Cited by 2 publications

(3 citation statements)

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“…However, the practitioner operates blindly during a traditional closed-blind pleural biopsy, resulting in lower diagnostic yields and inferior sensitivity rates compared to image-guided methods [ 29 , 30 ]. Ultrasound-guided pleural biopsy can overcome these limitations by providing a real-time imaging capability [ 9 ]. In the present trial, we found an initial sensitivity of 78% after the first ultrasound-guided pleural biopsy and a final sensitivity of 82% after the second ultrasound-guided pleural biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…To this end, image-guided pleural biopsies (i.e., ultrasound-guided or computer tomography (CT)-guided) have become popular modalities for diagnosing pleural effusions following inconclusive thoracentesis [ 8 ]. In particular, ultrasound-guided pleural biopsy shows certain practical advantages over CT-guided pleural biopsy, as ultrasound-guided procedures can be carried out in real-time at the bedside or on an outpatient basis, and do not involve costly CT facilities, complex CT positioning, or radiation exposure [ 9 ]. Although the diagnostic sensitivity of ultrasound-guided pleural biopsy in malignant pleural effusions has been verified [ 10 , 11 ], its diagnostic sensitivity in tuberculous pleurisy has not been reported.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided versus Thoracoscopic Pleural Biopsy for Diagnosing Tuberculous Pleurisy Following Inconclusive Thoracentesis: A Randomized, Controlled Trial

Zhou

Jiang

Xia³

et al. 2018

Med Sci Monit

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BackgroundTraditional diagnostic methods for tuberculosis (TB) cannot be reliably applied to tuberculous pleurisy. Therefore, this prospective, randomized, controlled trial was performed to compare the diagnostic sensitivity and safety of ultrasound-guided cutting-needle pleural biopsy versus thoracoscopic pleural biopsy in patients suspected of tuberculous pleurisy following inconclusive thoracentesis.Material/MethodsA total of 196 adult patients with acid-fast bacillus (AFB)-negative exudative pleural effusions clinically suspected of tuberculous pleurisy were recruited. Enrollees were randomized into 2 cohorts: ultrasound-guided cutting-needle pleural biopsy (n=96) or thoracoscopic pleural biopsy (n=96). The overall diagnostic yields, diagnostic sensitivities for tuberculous pleurisy, and post-procedural complications for both cohorts were statistically compared.ResultsUltrasound-guided pleural biopsy displayed an overall diagnostic yield of 83%, while thorascopic pleural biopsy displayed a similar overall diagnostic yield of 86% (χ2=1.88, df=1, p=0.17). There were 127 patients conclusively diagnosed with tuberculous pleurisy, resulting in a tuberculous pleurisy prevalence of 65% in this patient population (66% in the ultrasound cohort vs. 63% in the thoracoscopy cohort; p>0.05). Ultrasound-guided pleural biopsy displayed a sensitivity of 82% in detecting tuberculous pleurisy, while thorascopic pleural biopsy displayed a similar sensitivity of 90% (χ2=1.05, df=1, p=0.30). The sensitivities of these 2 modalities did not significantly differ based on the degree of pleural thickening (p>0.05). Post-procedural complications were minor.ConclusionsUltrasound-guided and thoracoscopic pleural biopsy both display strong (>80%) but statistically similar overall diagnostic yields for diagnosing pleural effusions following inconclusive thoracentesis. Both modalities also display strong (>80%) but statistically similar sensitivities in detecting tuberculous pleurisy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided versus Thoracoscopic Pleural Biopsy for Diagnosing Tuberculous Pleurisy Following Inconclusive Thoracentesis: A Randomized, Controlled Trial

Zhou

Jiang

Xia³

et al. 2018

Med Sci Monit

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show abstract

“…We thank Dr. Kuwal for his interest in and comments on our study [1]. In our randomized, prospective study, we aimed to compare computed tomography scan-guided pleural biopsy using an Abrams' needle (CT-ANPB) with ultrasonography-assisted pleural biopsy using a cutting needle (US-CNPB) with respect to both diagnostic yield and safety [2].…”

mentioning

confidence: 99%