Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2021

Open Access 01-12-2021 | Ultrasound | Research

Contrast-enhanced ultrasound guided pleural biopsy improves diagnostic confidence for pleural based lesions: a 3-year prospective study

Authors: Wenwen Sun, Yiming Zhou, Cong Yang, Zhengwei Dong, ZheMin Zhang, Yin Wang, Lin Fan

Published in: BMC Pulmonary Medicine | Issue 1/2021

Login to get access

Abstract

Objective

To evaluate the accuracy and safety of contrast-enhanced ultrasound (CEUS) guided biopsy in the diagnosis of radiologically determined pleural based lesions.

Method

A prospective study was conducted on patients with radiologically determined pleural based lesions. Patients who met the inclusion criteria received pleural biopsy guided by CEUS to obtain specimens, followed by histomathological and microbiological examinations. After treatment and follow-up, surgical thoracoscopy was performed on cases with undefinite diagnosis.

Result

A total of 460 patients were finally included. CEUS showed internal necrosis in 72.17% cases and obvious peripheral vessels in 55.43% cases, both of which were significantly higher than the conventional ultrasound imaged (p < 0.05). The diagnostic accuracy through CEUS guided biopsy sampling was 98.91% (455/460). The microbiological diagnostic yield achieved 71.88% (225/313) in infectious lesions. In 330 cases combined pleural effusion, CEUS guided biopsy increased the diagnostic yield from 60.30% (199 /330) to 98.36% (325 /330) in all cases (p < 0.05), from 15.56% (14/90) to 94.44% (85/90) in malignant lesions (p < 0.01) and from 77.08% (185/240) to 100% (240/240) in infectious lesions (p < 0.05). No serious adverse events occurred.

Conclusion

CEUS guided biopsy provides a minimally invasive, effective and safe diagnostic biopsy method for pleural lesions.
Clinical Trials Registration: Chinese Clinical Trial Registry ChiCTR2000029749 (ChiCTR, www.​chictr.​org.​cn).
Literature
1.
go back to reference Bhatnagar R, Corcoran JP, Maldonado F, et al. Advanced medical interventions in pleural disease. Eur Respir Rev. 2016;25:199–213.CrossRef Bhatnagar R, Corcoran JP, Maldonado F, et al. Advanced medical interventions in pleural disease. Eur Respir Rev. 2016;25:199–213.CrossRef
2.
go back to reference Dixon G, de Fonseka D, Maskell N. Pleural controversies: image guided biopsy vs. thoracoscopy for undiagnosed pleural effusions. J Thorac Dis. 2015;7:1041–51.PubMedPubMedCentral Dixon G, de Fonseka D, Maskell N. Pleural controversies: image guided biopsy vs. thoracoscopy for undiagnosed pleural effusions. J Thorac Dis. 2015;7:1041–51.PubMedPubMedCentral
3.
go back to reference Hallifax RJ, Haris M, Corcoran JP, Leyakathalikhan S, Brown E, Srikantharaja D, Manuel A, Gleeson FV, Munavvar M, Rahman NM. Role of CT in assessing pleural malignancy prior to thoracoscopy. Thorax. 2015;70(2):192–3.CrossRef Hallifax RJ, Haris M, Corcoran JP, Leyakathalikhan S, Brown E, Srikantharaja D, Manuel A, Gleeson FV, Munavvar M, Rahman NM. Role of CT in assessing pleural malignancy prior to thoracoscopy. Thorax. 2015;70(2):192–3.CrossRef
4.
go back to reference Sundaralingam A, Bedawi EO, Rahman NM. Diagnostics in pleural disease. Diagnostics (Basel). 2020;10(12):1046.CrossRef Sundaralingam A, Bedawi EO, Rahman NM. Diagnostics in pleural disease. Diagnostics (Basel). 2020;10(12):1046.CrossRef
5.
go back to reference Koegelenberg CFN, Irusen EM, Von Groote-Bidlingmaier F, et al. The utility of ultrasound-guided thoracentesis and pleural biopsy in undiagnosed pleural exudates. Thorax. 2015;70:995–7.CrossRef Koegelenberg CFN, Irusen EM, Von Groote-Bidlingmaier F, et al. The utility of ultrasound-guided thoracentesis and pleural biopsy in undiagnosed pleural exudates. Thorax. 2015;70:995–7.CrossRef
6.
go back to reference Khosla R, McLean AW, Smith JA. Ultrasound-guided versus computed tomography-scan-guided biopsy of pleural-based lung lesions. Lung India. 2016;33:487–92.CrossRef Khosla R, McLean AW, Smith JA. Ultrasound-guided versus computed tomography-scan-guided biopsy of pleural-based lung lesions. Lung India. 2016;33:487–92.CrossRef
7.
go back to reference Wang S, Yang W, et al. The role of contrast-enhanced ultrasound in selection indication and improving diagnosis for transthoracic biopsy in peripheral pulmonary and mediastinal lesions. Biomed Res Int. 2015;2015:231782.PubMedPubMedCentral Wang S, Yang W, et al. The role of contrast-enhanced ultrasound in selection indication and improving diagnosis for transthoracic biopsy in peripheral pulmonary and mediastinal lesions. Biomed Res Int. 2015;2015:231782.PubMedPubMedCentral
8.
go back to reference Dudau C, Hameed S, Gibson D, et al. Can contrast-enhanced ultrasound distinguish malignant from reactive lymph nodes in patients with head and neck cancers? Ultrasound Med Biol. 2014;40(4):747–54.CrossRef Dudau C, Hameed S, Gibson D, et al. Can contrast-enhanced ultrasound distinguish malignant from reactive lymph nodes in patients with head and neck cancers? Ultrasound Med Biol. 2014;40(4):747–54.CrossRef
9.
go back to reference Ying Fu, Yuan-Yuan Z, Li-Gang C, et al. Ultrasound-Guided Biopsy of Pleural-Based Pulmonary Lesions by Injection of Contrast-Enhancing Drugs. Front Pharmacol. 2019;10:960.CrossRef Ying Fu, Yuan-Yuan Z, Li-Gang C, et al. Ultrasound-Guided Biopsy of Pleural-Based Pulmonary Lesions by Injection of Contrast-Enhancing Drugs. Front Pharmacol. 2019;10:960.CrossRef
10.
go back to reference Sun W, Gu J, Bi K, et al. Clinical performance of Xpert MTB/RIF on contrast-enhanced ultrasound-guided core biopsy specimens for rapid diagnosis of superficial tuberculous lymphadenitis in high TB burden settings. Infection. 2021. Sun W, Gu J, Bi K, et al. Clinical performance of Xpert MTB/RIF on contrast-enhanced ultrasound-guided core biopsy specimens for rapid diagnosis of superficial tuberculous lymphadenitis in high TB burden settings. Infection. 2021.
11.
go back to reference Wenwen S, Yiming Z, Wenting L, et al. Diagnostic yield of Xpert MTB/RIF on contrast-enhanced ultrasound-guided pleural biopsy specimens for pleural tuberculosis. Int J Infect Dis. 2021;108:89–95.CrossRef Wenwen S, Yiming Z, Wenting L, et al. Diagnostic yield of Xpert MTB/RIF on contrast-enhanced ultrasound-guided pleural biopsy specimens for pleural tuberculosis. Int J Infect Dis. 2021;108:89–95.CrossRef
12.
go back to reference Sconfienza LM, Mauri G, Grossi F, et al. Pleural and peripheral lung lesions: comparison of US-and CT-guided biopsy. Radiology. 2013;266:930–5.CrossRef Sconfienza LM, Mauri G, Grossi F, et al. Pleural and peripheral lung lesions: comparison of US-and CT-guided biopsy. Radiology. 2013;266:930–5.CrossRef
13.
go back to reference Cao GQ, Li L, Wang YB, Shi ZZ, Fan DY, Chen HY. Treatment of free-flowing tuberculous pleurisy with intrapleural urokinase. Int J Tuberc Lung Dis. 2015;19(11):1395–400.CrossRef Cao GQ, Li L, Wang YB, Shi ZZ, Fan DY, Chen HY. Treatment of free-flowing tuberculous pleurisy with intrapleural urokinase. Int J Tuberc Lung Dis. 2015;19(11):1395–400.CrossRef
14.
go back to reference Richard M, Philippa R, Anil P, et al. Same-day tools, including Xpert ultra and IRISA-TB, for rapid diagnosis of pleural tuberculosis: a prospective observational study. J Clin Microbiol. 2019;57(9):e00614-e619. Richard M, Philippa R, Anil P, et al. Same-day tools, including Xpert ultra and IRISA-TB, for rapid diagnosis of pleural tuberculosis: a prospective observational study. J Clin Microbiol. 2019;57(9):e00614-e619.
15.
go back to reference Maturu VN, Dhooria S, Bal A, et al. Role of medical thoracoscopy and closed-blind pleural biopsy (CPB) in undiagnosed exudative pleural effusions: a single-center experience of 348 patients. J Bronchology Interv Pulmonol. 2015;22:121–9.CrossRef Maturu VN, Dhooria S, Bal A, et al. Role of medical thoracoscopy and closed-blind pleural biopsy (CPB) in undiagnosed exudative pleural effusions: a single-center experience of 348 patients. J Bronchology Interv Pulmonol. 2015;22:121–9.CrossRef
16.
go back to reference Hallifax RJ, Corcoran JP, Ahmed A, et al. Physician-based ultrasound-guided biopsy for diagnosing pleural disease. Chest. 2014;146(4):1001–6.CrossRef Hallifax RJ, Corcoran JP, Ahmed A, et al. Physician-based ultrasound-guided biopsy for diagnosing pleural disease. Chest. 2014;146(4):1001–6.CrossRef
17.
go back to reference Davies HE, Davies RJ, Davies CW, et al. Management of pleural infection in adults: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(5):ii41.PubMed Davies HE, Davies RJ, Davies CW, et al. Management of pleural infection in adults: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(5):ii41.PubMed
18.
go back to reference Lee YCG, Fitzgerald DB. Pleural biopsy to capture causative microbe: a new piece of the pleural infection jigsaw. Chest. 2018;154:743–5.CrossRef Lee YCG, Fitzgerald DB. Pleural biopsy to capture causative microbe: a new piece of the pleural infection jigsaw. Chest. 2018;154:743–5.CrossRef
19.
go back to reference Psallidas I, Kanellakis NI, Bhatnager R, et al. A pilot feasibility study in establishing the role of ultrasound-guided pleural biopsies in pleural infection (The AUDIO study). Chest. 2018;154(4):766–72.CrossRef Psallidas I, Kanellakis NI, Bhatnager R, et al. A pilot feasibility study in establishing the role of ultrasound-guided pleural biopsies in pleural infection (The AUDIO study). Chest. 2018;154(4):766–72.CrossRef
20.
go back to reference Chirieac LR, Hung YP, Foo WC, et al. Diagnostic value of biopsy sampling in predicting histology in patients with diffuse malignant pleural mesothelioma. Cancer. 2019;125:4164–71.CrossRef Chirieac LR, Hung YP, Foo WC, et al. Diagnostic value of biopsy sampling in predicting histology in patients with diffuse malignant pleural mesothelioma. Cancer. 2019;125:4164–71.CrossRef
21.
go back to reference Del Colle A, Sperandeo M, Rea G, Lacedonia D, Frongillo EM, Cipriani C, et al. Value of contrast-enhanced ultrasound in guidance of percutaneous biopsy in peripheral lung carcinoma. Chest. 2019;155(6):A370.CrossRef Del Colle A, Sperandeo M, Rea G, Lacedonia D, Frongillo EM, Cipriani C, et al. Value of contrast-enhanced ultrasound in guidance of percutaneous biopsy in peripheral lung carcinoma. Chest. 2019;155(6):A370.CrossRef
Metadata
Title
Contrast-enhanced ultrasound guided pleural biopsy improves diagnostic confidence for pleural based lesions: a 3-year prospective study
Authors
Wenwen Sun
Yiming Zhou
Cong Yang
Zhengwei Dong
ZheMin Zhang
Yin Wang
Lin Fan
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2021
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-021-01583-7

Other articles of this Issue 1/2021

BMC Pulmonary Medicine 1/2021 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.