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Research progress on imaging prediction of pleural adhesion: a narrative review

Yun Wang¹, Deng Lyu¹, Wenting Tu¹

¹Department of Radiology, The Second Affiliated Hospital of Navy Medical University, Shanghai, China.

Journal of Thoracic Disease

|March 12, 2026

Abstract

Background And Objective:

Pleural adhesion is a significant risk factor that can lead to a poor prognosis in thoracic surgery. The extent of these adhesions directly affects the selection of preoperative surgical approaches, the progress of the intraoperative surgical process, and the occurrence of serious postoperative complications. Accurate preoperative judgment of pleural adhesions and their severity is of great significance for formulating perioperative treatment plans and achieving precision medicine. This article focuses on summarizing and synthesizing various imaging methods for preoperative prediction of pleural adhesions and discusses the challenges and prospects facing future research. The aim is to improve preoperative diagnostic accuracy and risk stratification, thereby enhancing surgical safety and efficacy.

Methods:

A comprehensive, non-systematic review of the latest literature was carried out in order to investigate the progress of predicting pleural adhesions. PubMed database was being examined, and the last run was on December 17^th 2025.

Key Content And Findings:

This article reviews the definition, classification, and clinical significance of pleural adhesions, and summarizes the latest research progress of imaging prediction of pleural adhesions in the past 10 years. It was found that ultrasound, chest X-ray, computed tomography (CT), and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/CT can all effectively predict the pleural adhesion status before the operation.

Conclusions:

Pleural adhesions influence the survival prognosis of patients with thoracic surgery. Effective preoperative prediction of the state of pleural adhesions can help to improve the preoperative surgical plan formulation and reduce the occurrence of postoperative complications. Ultrasound, chest X-ray, CT, and ¹⁸F-FDG PET/CT have their advantages and disadvantages in predicting pleural adhesions, and artificial intelligence (AI) may be the direction of future research.

Keywords:

Pleural adhesion imaging prediction preoperative

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