Correlation between CT findings and thoracoscopic diagnosis in diffuse pleural disease

Area of Science:

• Radiology
• Oncology
• Thoracic Surgery

Background:

• Computed Tomography (CT) is integral to diagnosing pleural malignancy.
• Histological confirmation via pleural biopsy is the gold standard for definitive diagnosis.
• Advancements in imaging necessitate re-evaluation of CT's diagnostic performance.

Purpose of the Study:

• To assess the sensitivity and specificity of modern CT imaging in detecting pleural malignancy.
• To compare CT-based detection rates against definitive histology obtained through Video-Assisted Thoracoscopic Surgery (VATS).

Main Methods:

• Retrospective analysis of 90 patients with suspected pleural malignancy.
• CT scans were evaluated by radiologists blinded to histopathology results.
• Diagnosis was confirmed by VATS biopsy.

Main Results:

• CT demonstrated high sensitivity and specificity for various malignant pleural signs.
• Nodular pleural thickening showed high sensitivity (0.86) and specificity (0.75).
• Combined CT features, like nodular thickening with mediastinal involvement, yielded high diagnostic performance (Se 0.83, Sp 0.90).

Conclusions:

• CT plays a crucial role in diagnosing pleural malignancy.
• High sensitivity, particularly for nodular thickening, may alter diagnostic strategies.
• CT may reduce reliance on VATS, favoring image-guided biopsies for non-surgical candidates.