Evaluation of parietal pleural adhesion and invasion in subpleural lung cancer: value of B-mode ultrasound and...

Area of Science:

• Medical imaging
• Oncology
• Pulmonology

Background:

• Parietal pleural adhesion/invasion in lung cancer correlates with poor prognosis and surgical complexity.
• The diagnostic utility of ultrasound for assessing parietal pleural involvement in lung cancer is not well-established.
• This study aimed to evaluate B-mode ultrasound and contrast-enhanced ultrasound (CEUS) for diagnosing parietal pleural adhesion/invasion in subpleural lung cancer.

Purpose of the Study:

• To investigate the diagnostic value of B-mode ultrasound and CEUS in identifying parietal pleural adhesion/invasion in subpleural lung cancer.
• To compare the accuracy and interrater reliability of B-mode ultrasound versus CEUS for this specific diagnostic task.

Main Methods:

• A rabbit model of subpleural lung cancer was created using VX2 tumor tissue injection under ultrasound guidance.
• Parietal pleural adhesion/invasion was assessed using B-mode ultrasound and CEUS by two sonographers in 34 rabbits.
• Gold standard confirmation was obtained through anatomical and pathological examination.

Main Results:

• CEUS achieved higher diagnostic accuracy (94.1% and 91.2%) compared to B-mode ultrasound (70.6% and 64.7%) for both sonographers.
• CEUS demonstrated superior interrater reliability (κ=0.941) compared to B-mode ultrasound (κ=0.717).
• While both methods showed diagnostic efficacy, CEUS significantly improved accuracy for one sonographer and showed a non-significant trend for the other.

Conclusions:

• Both B-mode ultrasound and CEUS are effective in evaluating parietal pleural adhesion/invasion in subpleural lung cancer using an animal model.
• CEUS offers superior diagnostic accuracy and interrater reliability compared to B-mode ultrasound for this indication.
• These findings suggest CEUS may be a valuable tool for assessing lung cancer pleural involvement.