دورية أكاديمية
Image-Assısted Pleural Needle Biopsy or Medical Thoracoscopy: Which Method for Which Patient? A Randomızed Controlled Trial.
| العنوان: | Image-Assısted Pleural Needle Biopsy or Medical Thoracoscopy: Which Method for Which Patient? A Randomızed Controlled Trial. |
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| المؤلفون: | Metintas M; Department of Chest Diseases, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey; Lung and Pleural Cancers Clinical and Research Center, Eskisehir Osmangazi University, Eskisehir, Turkey. Electronic address: muzaffermetintas@gmail.com., Ak G; Department of Chest Diseases, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey; Lung and Pleural Cancers Clinical and Research Center, Eskisehir Osmangazi University, Eskisehir, Turkey., Yildirim H; Department of Chest Diseases, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey., Dundar E; Department of Pathology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey., Aydin N; Department of Radiology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey., Erginel S; Department of Chest Diseases, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey., Alatas F; Department of Chest Diseases, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey., Yilmaz S; Department of Chest Diseases, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey., Metintas S; Department of Public Health, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey. |
| المصدر: | Chest [Chest] 2024 Aug; Vol. 166 (2), pp. 405-412. Date of Electronic Publication: 2024 Mar 28. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 0231335 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1931-3543 (Electronic) Linking ISSN: 00123692 NLM ISO Abbreviation: Chest Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2016- : New York : Elsevier Original Publication: Chicago : American College of Chest Physicians |
| مواضيع طبية MeSH: | Thoracoscopy*/methods , Image-Guided Biopsy*/methods , Pleural Effusion*/diagnosis , Pleural Effusion*/pathology, Humans ; Male ; Female ; Middle Aged ; Prospective Studies ; Biopsy, Needle/methods ; Biopsy, Needle/adverse effects ; Aged ; Tomography, X-Ray Computed/methods ; Pleura/pathology ; Pleura/diagnostic imaging ; Reproducibility of Results ; Sensitivity and Specificity ; Adult |
| مستخلص: | Background: Image-guided or assisted needle biopsies and the increasing use of medical thoracoscopy (MT) have increased the diagnostic accuracy of pleural diseases significantly. However, no consensus exists regarding which patients with pleural effusion should undergo MT and which patients should undergo image-guided or assisted needle biopsy as the first procedure to ensure greater diagnostic accuracy. Research Question: Which biopsy method is more appropriate for which patient to provide the highest diagnostic accuracy in the diagnosis of pleural effusion? Study Design and Methods: This prospective, randomized, parallel study included 228 patients with undiagnosed exudative pleural effusion. Patients were divided into two groups based on CT scan findings. Group 1 included patients with pleural effusion only. Group 2 included patients with pleural thickening or lesion in addition to pleural effusion. Patients in each group were assigned randomly to an image-assisted Abrams needle pleural biopsy (IA-ANPB) or MT arm. The diagnostic sensitivity, reliability, and safety were determined for both groups. Results: The false-negative rate was 30.3% for the IA-ANPB arm and 3.1% for the MT arm in group 1. The same rates were 11.9% for IA-ANPB and 4.7% for MT in group 2. In group 1, the sensitivity for the IA-ANPB arm was 69.7%, and the negative likelihood ratio was 0.30. The same rates for the MT arm were 96.9% and 0.03 (P = .009). In group 2, these values were 88.1% and 0.12 for the IA-ANPB arm and 95.4% and 0.05 for the MT arm (P = .207). The rate of complications between the two biopsy methods was not different (8.5% and 15.8%, respectively; P = .107). Interpretation: MT showed a high diagnostic success in all patients with pleural fluid. However, IA-ANPB showed similar diagnostic success as MT in patients with pleural effusion and associated pleural thickening or lesions. Therefore, in the latter case, IA-ANPB could be preferable to MT. Trial Registry: ClinicalTrials.gov; No.: NCT05428891; URL: www. Clinicaltrials: gov. Competing Interests: Financial/Nonfinancial Disclosures None declared. (Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: CT scan; diagnosis; needle biopsy; pleura; thoracoscopy; ultrasonography |
| سلسلة جزيئية: | ClinicalTrials.gov NCT05428891 |
| تواريخ الأحداث: | Date Created: 20240330 Date Completed: 20240809 Latest Revision: 20240809 |
| رمز التحديث: | 20240812 |
| DOI: | 10.1016/j.chest.2024.03.038 |
| PMID: | 38554817 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1931-3543 |
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| DOI: | 10.1016/j.chest.2024.03.038 |