Parietal pleural plaques: a comparison between autopsy and X-ray findings

Area of Science:

• Pulmonary Medicine
• Radiology
• Pathology

Background:

• Parietal pleural plaques (PP) are common findings, particularly in males over 40.
• Previous studies suggest varying accuracy in diagnosing PP via chest roentgenography.

Purpose of the Study:

• To evaluate the accuracy of chest roentgenography in detecting parietal pleural plaques.
• To investigate factors influencing the diagnostic accuracy of roentgenological examination for PP.

Main Methods:

• Retrospective analysis of 402 autopsies to identify PP.
• Comparison of pre-mortem chest roentgenographs with autopsy findings.
• Blind review of X-rays by experienced readers to assess PP detection rates.

Main Results:

• Parietal pleural plaques were found in 26.9% of males and 3.1% of females over 40.
• Roentgenological diagnosis suggested PP in less than half of confirmed cases.
• Plaque thickness significantly affected diagnostic accuracy, while area did not correlate.
• A notable number of false positives/uncertain findings were observed in cases without PP.

Conclusions:

• Chest roentgenography has limited sensitivity for detecting parietal pleural plaques.
• Plaque thickness is a critical factor influencing the accuracy of roentgenological diagnosis.
• Radiological assessment of PP may be unreliable, especially with suboptimal image quality or views.