The value of computed tomography for predicting empyema-associated malignancy

Area of Science:

• Radiology
• Oncology
• Thoracic Surgery

Background:

• Chronic empyema is a persistent pleural infection.
• Malignancy can occur secondary to chronic empyema.
• Accurate detection of empyema-associated malignancy (EAM) is crucial for patient management.

Purpose of the Study:

• To evaluate the diagnostic value of computed tomography (CT) in identifying malignancy in patients with chronic empyema.
• To identify specific CT findings predictive of empyema-associated malignancy (EAM).

Main Methods:

• Retrospective review of CT scans from 112 patients with chronic empyema.
• Analysis of CT findings including empyema sac mass, pleural involvement, and lymphadenopathy.
• Statistical analysis (Fisher exact test, logistic regression) to correlate CT findings with confirmed EAM.

Main Results:

• Most CT findings were significantly associated with EAM (P<0.05), except rib involvement and bulging.
• Mass, extrapleural fat, and mediastinal involvement demonstrated high sensitivity and specificity.
• Logistic regression identified mass presence and mediastinal pleural involvement as significant predictors of EAM.

Conclusions:

• CT scanning reveals multiple findings associated with EAM in chronic empyema.
• While some CT findings have high sensitivity, many lack high positive predictive value.
• A comprehensive assessment of various CT features is recommended for detecting EAM.