Utility of semi-rigid thoracoscopy in undiagnosed exudative pleural effusion

Loganathan, N; Madan, Karan; Hadda, Vijay; Jain, Deepali; Madan, Neha Kawatra; Arava, Sudheer; Khilnani, Gopi C; Guleria, Randeep

doi:10.4103/0970-2113.152618

Cited by 29 publications

(11 citation statements)

References 22 publications

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“…It has been gradually applied in the differential diagnosis of pleural effusion. It can not only determine whether there is pleural effusion but also determine the cause and nature of pleural effusion through indirect signs such as chest and pleura [ 21 ].…”

Section: Energy Spectrum Ct Evaluation Of Pleural Effusion Benign mentioning

confidence: 99%

CAMPO Precision128 Max ENERGY Spectrum CT Combined with Multiple Parameters to Evaluate the Benign and Malignant Pleural Effusion

Zhang

et al. 2021

Journal of Healthcare Engineering

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The emergence of energy spectrum CT provides greater diagnostic value for clinical practice. Its advantage is that it can provide more functional imaging parameters and accurate image information for clinical practice, which represents a mainstream direction of CT technology development at present. This paper mainly studies the clinical trial of CAMPO Precision128 Max ENERGY spectrum CT combined with multiple parameters to evaluate the benign and malignant pleural effusion. This paper analyzes the principle and key performance parameters of energy spectrum CT imaging, the etiology of pleural effusion, and its conventional diagnostic methods and uses energy spectrum CT to detect the benign and malignant pleural effusion. In this paper, two groups of patients with different types of pleural effusions were scanned by line spectrum chest CT scans, and energy spectrum analysis software was used to measure and calculate the CT values of conventional mixed energy values of ROI of patients with pleural effusions. For the CT value and energy curve slope measurement value of different single energy keV, independent sample t-test was used to analyze and compare the two sets of data, and finally it has been found out that the two sets of data were similar. According to the experimental results, the curves of energy spectrum of the two groups of data are similar in the descending curve of bow-back. The slope of energy spectrum curve in the leakage group was lower than that in the exudate group, showing statistical significance ( P < 0.05 ). The slope of energy spectrum curve K in the malignant pleural effusion group was significantly higher than that in the benign pleural effusion group, and the difference was statistically significant ( P < 0.05 ). The trend of energy spectrum curves of the two is roughly the same, while at the high energy level, part of the energy spectrum curves of the two are overlapped. The above conclusion indicates that energy spectrum CT plays a certain role in the differential diagnosis of pleural effusion. At the same time, energy spectrum CT also provides a noninvasive and rapid examination method for clinical differentiation of pleural effusion, which has certain clinical application value and prospect.

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Section: Energy Spectrum Ct Evaluation Of Pleural Effusion Benign mentioning

confidence: 99%

CAMPO Precision128 Max ENERGY Spectrum CT Combined with Multiple Parameters to Evaluate the Benign and Malignant Pleural Effusion

Zhang

et al. 2021

Journal of Healthcare Engineering

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“…Parenchymal infiltrates and masses, pleural thickening and masses, mediastinal lymphadenopathy, and PE can be diagnosed with these scans. If the diagnosis is still elusive, thoracoscopy and pleural biopsy are recommended [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

An interesting case of undiagnosed pleural effusion

Panjwani

Zaid

2017

Breathe

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Pleural effusions are commonly encountered in the clinical practise of both respiratory and nonrespiratory specialists. An estimated 1–1.5 million new cases in the USA and 200 000–250 000 new cases of pleural effusions are reported from the UK each year [1]. Analysis of the relevant clinical history, physical examination, chest radiography and diagnostic thoracentesis is useful in identifying the cause of pleural effusion in majority of the cases [2]. In a few cases, the aetiology may be unclear after the initial assessment. The list of diseases that may account for a persistent undiagnosed pleural effusion is long [3]. We present an interesting case of undiagnosed pleural effusion that was encountered in our hospital.

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“…The currently available data indicate that, in cases where aspiration cytology reveals negativity for exudative PE, thoracoscopy under local anesthetic is among the techniques with the highest diagnostic ability; the method has about 88–96% diagnostic sensitivity for malignant pleural disease. [ 10 11 12 ] However, such invasive examinations cannot be performed in the elderly, or in those in poor physical condition. Uncontrollable coughing from pleural irritation also contraindicates thoracoscopy, as it is hazardous to access and visualize the whole pleura in such cases.…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Tumor Markers for Determining Cause of Pleural Effusion

Zhai²,

Shi

2016

Chinese Medical Journal

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Background:It is often challenging to distinguish tuberculous pleural effusion (TPE) from malignant pleural effusion (MPE); thoracoscopy is among the techniques with the highest diagnostic ability in this regard. However, such invasive examinations cannot be performed on the elderly, or on those in poor physical condition. The aim of this study was to explore the differential diagnostic value of carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and squamous cell carcinoma (SCC) associated antigen in patients with TPE and MPE.Methods:Using electrochemiluminescence, we measured the concentration of tumor markers (TMs) in the pleural effusion and serum of patients with TPE (n = 35) and MPE (n = 95). We used receiver operating characteristic (ROC) curve analysis to evaluate the TMs and differentiate between TPE and MPE.Results:The cut-off values for each TM in serum were: CA125, 151.55 U/ml; CA199, 9.88 U/ml; CEA, 3.50 ng/ml; NSE, 13.27 ng/ml; and SCC, 0.85 ng/ml. Those in pleural fluid were: CA125, 644.30 U/ml; CA199, 12.08 U/ml; CEA, 3.35 ng/ml; NSE, 9.71 ng/ml; and SCC, 1.35 ng/ml. The cut-off values for the ratio of pleural fluid concentration to serum concentration (P/S ratio) of each TM were: CA125, 5.93; CA199, 0.80; CEA, 1.47; NSE, 0.76; and SCC, 0.90. The P/S ratio showed the highest specificity in the case of CEA (97.14%). ROC curve analysis revealed that, for all TMs, the area under the curve in pleural fluid (0.95) was significantly different from that in serum (0.85; P < 0.001).Conclusions:TMs in TPE differ significantly from those in MPE, especially when detected in pleural fluid. The combined detection of TMs can improve diagnostic sensitivity.

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Utility of semi-rigid thoracoscopy in undiagnosed exudative pleural effusion

Cited by 29 publications

References 22 publications

CAMPO Precision128 Max ENERGY Spectrum CT Combined with Multiple Parameters to Evaluate the Benign and Malignant Pleural Effusion

CAMPO Precision128 Max ENERGY Spectrum CT Combined with Multiple Parameters to Evaluate the Benign and Malignant Pleural Effusion

An interesting case of undiagnosed pleural effusion

Clinical Value of Tumor Markers for Determining Cause of Pleural Effusion

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