Diagnostic Accuracy of Shear Wave Elastography in Predicting Malignant Origins of Pleural Effusions in Emergency Departments.

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Diagnostics Pub Date : 2025-01-20 DOI:10.3390/diagnostics15020225
Rune Wiig Nielsen, Casper Falster, Stefan Posth, Niels Jacobsen, August Emil Licht, Rahul Bhatnagar, Christian Borbjerg Laursen
{"title":"Diagnostic Accuracy of Shear Wave Elastography in Predicting Malignant Origins of Pleural Effusions in Emergency Departments.","authors":"Rune Wiig Nielsen, Casper Falster, Stefan Posth, Niels Jacobsen, August Emil Licht, Rahul Bhatnagar, Christian Borbjerg Laursen","doi":"10.3390/diagnostics15020225","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective</b>: Ultrasound is a valuable diagnostic tool in the diagnostic work-up of dyspnea and can identify even small pleural effusions. The incorporation of shear wave elastography (SWE) represents a possible tool in stratifying pleural effusions by the risk of underlying malignancy. No previous studies on ultrasound with the incorporation of SWE have been conducted in an emergency department (ED), where such stratification might have a clinical impact by hastening referrals for the diagnostic work-up of underlying malignancy. The objective of this study was to appraise the diagnostic accuracy of ultrasonographic findings associated with thoracic malignancy as well as to calculate the optimal cutoff values for SWE in this regard. <b>Methods</b>: Patients with a unilateral pleural effusion of unknown origin were included in the ED and subjected to a thoracic ultrasound (TUS) scan during their first 48 h after admittance. Two index tests were applied: (i) traditional B-mode TUS examination registering the presence of diaphragmatic nodules, pleural thickenings and other findings associated with malignancy and (ii) an SWE examination of different regions of interest. The reference test was defined as the subsequent diagnosis of malignant pleural effusion (MPE) in the three months following inclusion. <b>Results</b>: In total, 39 patients were included. The B-mode TUS index test yielded a sensitivity of 28.57% (95%CI 3.67-70.96%) and a specificity of 90.62% (95%CI 74.98-98.02%). The SWE max of the intercostal space yielded a sensitivity of 100% (95%CI 47.82-100%) and a specificity of 59.09% (95%CI 36.35-79.29%). <b>Conclusions</b>: A TUS with integrated SWE may aid in identifying MPEs and improving referrals for the diagnostic work-up of underlying malignancy. Larger, adequately powered studies are warranted.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 2","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765148/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/diagnostics15020225","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Ultrasound is a valuable diagnostic tool in the diagnostic work-up of dyspnea and can identify even small pleural effusions. The incorporation of shear wave elastography (SWE) represents a possible tool in stratifying pleural effusions by the risk of underlying malignancy. No previous studies on ultrasound with the incorporation of SWE have been conducted in an emergency department (ED), where such stratification might have a clinical impact by hastening referrals for the diagnostic work-up of underlying malignancy. The objective of this study was to appraise the diagnostic accuracy of ultrasonographic findings associated with thoracic malignancy as well as to calculate the optimal cutoff values for SWE in this regard. Methods: Patients with a unilateral pleural effusion of unknown origin were included in the ED and subjected to a thoracic ultrasound (TUS) scan during their first 48 h after admittance. Two index tests were applied: (i) traditional B-mode TUS examination registering the presence of diaphragmatic nodules, pleural thickenings and other findings associated with malignancy and (ii) an SWE examination of different regions of interest. The reference test was defined as the subsequent diagnosis of malignant pleural effusion (MPE) in the three months following inclusion. Results: In total, 39 patients were included. The B-mode TUS index test yielded a sensitivity of 28.57% (95%CI 3.67-70.96%) and a specificity of 90.62% (95%CI 74.98-98.02%). The SWE max of the intercostal space yielded a sensitivity of 100% (95%CI 47.82-100%) and a specificity of 59.09% (95%CI 36.35-79.29%). Conclusions: A TUS with integrated SWE may aid in identifying MPEs and improving referrals for the diagnostic work-up of underlying malignancy. Larger, adequately powered studies are warranted.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
期刊最新文献
The Value of Clinical Decision Support in Healthcare: A Focus on Screening and Early Detection. Pain-Related White-Matter Changes Following Mild Traumatic Brain Injury: A Longitudinal Diffusion Tensor Imaging Pilot Study. Performance Comparison of Two In-House PCR Methods for Detecting Neisseria meningitidis in Asymptomatic Carriers and Antimicrobial Resistance Profiling. Fine-Tuned Machine Learning Classifiers for Diagnosing Parkinson's Disease Using Vocal Characteristics: A Comparative Analysis. Comparing ChatGPT 4.0's Performance in Interpreting Thyroid Nodule Ultrasound Reports Using ACR-TI-RADS 2017: Analysis Across Different Levels of Ultrasound User Experience.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1