Thoracic ultrasound for malignant pleural effusion: a systematic review and meta-analysis

Shiroshita, Akihiro; Nozaki, Sayumi; Tanaka, Yu; Luo, Yan; Kataoka, Yuki

doi:10.1183/23120541.00464-2020

Cited by 14 publications

(11 citation statements)

References 19 publications

(31 reference statements)

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“…For malignant PEs, the cytological examination obtained by ultrasound-guided thoracocentesis is the key to diagnosis, but it has variable sensitivity from 45.5% to 87.9%, depending on the type of disease [4]. Therefore, repeated specimen collection, invasive procedures such as pleural biopsy, and, ultimately, thoracoscopy are recommended for Diagnostics 2021, 11, 1293 2 of 13 improving the diagnosis if the first specimen does not provide a definitive diagnosis [5][6][7]. However, all these procedures are invasive and may be associated with complications, such as pneumothorax and bleeding [8].…”

Section: Introductionmentioning

confidence: 99%

“…Görg et al proved in 1997 that, with B-TUS, the detection of pleural masses could be considered characteristic of a malignant effusion [9]. Despite its high specificity, B-TUS shows low sensitivity in detecting malignant PEs [13]. One of the methods to improve the sensitivity of B-TUS for the detection of malignant thoracic pathology is the use of contrast-enhanced ultrasound (CEUS) [14].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Accuracy of B-Mode- and Contrast-Enhanced Ultrasound in Differentiating Malignant from Benign Pleural Effusions

et al. 2021

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Purpose: To evaluate the value of CEUS in differentiating malignant from benign pleural effusions (PEs). Methods: From 2008 to 2017, 83 patients with PEs of unknown cause were examined using B-mode thoracic ultrasound (B-TUS), CEUS, and cytological examination. The extent of enhancement of the pleural thickening, the presence of enhancement of septa or a solid mass within the PE, and the homogeneity of the enhancement in the associated lung consolidation, were examined. Subsequently, the diagnostic value of cytology, B-TUS, and CEUS in differentiating malignant from benign PEs was determined. Results: With CEUS, markedly enhanced pleural thickening and inhomogeneous enhanced lung consolidation were significantly more frequently associated with malignancy (p < 0.05). In the subgroup analysis, the use of CEUS increased the sensitivity from 69.2 to 92.3 in patients with initial negative cytology but clinical suspicion of malignant PE; it also increased the specificity from 63.0 to 90.0, the positive predictive value from 69.2 to 92.3, the negative predictive value from 63.0 to 90.0, and the diagnostic accuracy from 66.7 to 87.5, in the evaluation of PE malignancy. Conclusion: The use of clinically based B-TUS and CEUS as a complementary method to cytological evaluation may be beneficial for evaluating a PE of unknown cause. CEUS patterns of enhanced pleural thickening and inhomogeneous enhanced lung consolidation may suggest a malignant PE.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of B-Mode- and Contrast-Enhanced Ultrasound in Differentiating Malignant from Benign Pleural Effusions

et al. 2021

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“…To address topics other than COVID-19, we used several previous DTA systematic reviews, including those on malignancy, 18 gastrointestinal disorders, 19 respiratory disorders, 20 emergency care, 21,22 neurology, [23][24][25] and infectious disease. 26,27 Some search data were not stored in a reusable form, and fewer records were included than those retrieved for the original studies.…”

Section: Preparation Of Datasetsmentioning

confidence: 99%

An open competition involving thousands of competitors failed to construct useful abstract classifiers for new diagnostic test accuracy systematic reviews

Kataoka

Taito

Yamamoto

et al. 2023

Research Synthesis Methods

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There are currently no abstract classifiers, which can be used for new diagnostic test accuracy (DTA) systematic reviews to select primary DTA study abstracts from database searches. Our goal was to develop machine‐learning‐based abstract classifiers for new DTA systematic reviews through an open competition. We prepared a dataset of abstracts obtained through database searches from 11 reviews in different clinical areas. As the reference standard, we used the abstract lists that required manual full‐text review. We randomly splitted the datasets into a train set, a public test set, and a private test set. Competition participants used the training set to develop classifiers and validated their classifiers using the public test set. The classifiers were refined based on the performance of the public test set. They could submit as many times as they wanted during the competition. Finally, we used the private test set to rank the submitted classifiers. To reduce false exclusions, we used the Fbeta measure with a beta set to seven for evaluating classifiers. After the competition, we conducted the external validation using a dataset from a cardiology DTA review. We received 13,774 submissions from 1429 teams or persons over 4 months. The top‐honored classifier achieved a Fbeta score of 0.4036 and a recall of 0.2352 in the external validation. In conclusion, we were unable to develop an abstract classifier with sufficient recall for immediate application to new DTA systematic reviews. Further studies are needed to update and validate classifiers with datasets from other clinical areas.

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“…Dazu gehören eine Pleuraverdickung (>1 cm), eine Zwerchfellverdickung (>7 mm) und eine Pleuraknötchenbildung [17]. Wie eine aktuelle systematische Übersichtsarbeit und Metaanalyse zeigt, ist die Thoraxsonographie jedoch nicht geeignet, um die Diagnose eines MPEs auszuschließen [18]. Die Ultraschalluntersuchung hat sich zum Standard für die diagnostische Pleurapunktion bei MPE entwickelt, insbesondere bei der Auswahl der Stelle, der Verringerung der Komplikationsrate und der Beurteilung der Lungenexpansion nach der Drainage [19].…”

Section: Diagnoseunclassified

Diagnose und Management von malignem Pleuraerguss: Ein Jahrzehnt im Rückblick

Jacobs¹,

Sheikh²,

Youness³

et al. 2022

Kompass Pneumol

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Ein maligner Pleuraerguss (MPE) ist eine häufige Komplikation von thorakalen und extrathorakalen Malignomen und geht mit einer hohen Sterblichkeit einher. Die Behandlung ist hauptsächlich palliativ, wobei die Symptome durch Ergussdrainage und Pleurodese gelindert werden. Die Pleurodese kann durch die Verabreichung eines Sklerosierungsmittels über eine Thorakostomie-Sonde, eine Thorakoskopie oder einen Pleuraverweilkatheter (IPC) beschleunigt werden. In den letzten zehn Jahren haben mehrere randomisierte, kontrollierte Studien das derzeitige Management von MPE zugunsten eines ambulanten Ansatzes geprägt, wobei der Einsatz von IPC deutlich zugenommen hat. Die Präferenzen der Patienten sind nach wie vor entscheidend für die Wahl der optimalen Therapie, insbesondere wenn die Lunge erweiterbar ist. In dieser Übersichtsarbeit haben wir die MPE-Literatur der letzten 10 bis 15 Jahre durchgesehen und uns dabei besonders auf die Diagnose und das sich entwickelnde Management konzentriert.

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Thoracic ultrasound for malignant pleural effusion: a systematic review and meta-analysis

Cited by 14 publications

References 19 publications

Diagnostic Accuracy of B-Mode- and Contrast-Enhanced Ultrasound in Differentiating Malignant from Benign Pleural Effusions

Diagnostic Accuracy of B-Mode- and Contrast-Enhanced Ultrasound in Differentiating Malignant from Benign Pleural Effusions

An open competition involving thousands of competitors failed to construct useful abstract classifiers for new diagnostic test accuracy systematic reviews

Diagnose und Management von malignem Pleuraerguss: Ein Jahrzehnt im Rückblick

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