Observational studyLung cancer (Amsterdam, Netherlands)2017
The diagnostic performance of routinely acquired and reported computed tomography imaging in patients presenting with suspected pleural malignancy.
Observational study in Lung cancer (Amsterdam, Netherlands), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Pooled it
- Review
- Updates in the management of malignant pleural effusion: a clinical practice review.Journal of thoracic disease · 2025Review
- Retrospective analysis of the sensitivity of reporting of thoracic computed tomography for pleural malignancy: an Australian multi-centre study.Journal of thoracic disease · 2025Article
- Emerging Radiopharmaceuticals in Pet Imaging for Mesothelioma: A Review of [Molecular diagnosis & therapy · 2025Review
- Diagnosis of Pleural Mesothelioma: Is Everything Solved at the Present Time?Current oncology (Toronto, Ont.) · 2024Review
- Added value of 40 keV virtual monoenergetic images for diagnosing malignant pleural effusion on chest CT.Japanese journal of radiology · 2024Article
- Contemporary management of mesothelioma.Breathe (Sheffield, England) · 2024Review
- Imaging of pleural disease.Breathe (Sheffield, England) · 2024Review
- Staging by Thoracoscopy in potentially radically treatable Lung Cancer associated with Minimal Pleural Effusion (STRATIFY): protocol of a prospective, multicentre, observational study.BMJ open respiratory research · 2023Article
- Observational
- How can we use positron emission tomography/computed tomography more accurately for characterization of asbestos-related pleural thickening?Archives of medical science : AMS · 2023Article
- Possible Role of Chest Ultrasound in the Assessment of Costo-Phrenic Angle Lesions Prior to Medical Thoracoscopy: A Retrospective Pilot Case Series.Diagnostics (Basel, Switzerland) · 2022Article
- Diffusion-weighted imaging diagnostic algorithm in patients with suspected pleural malignancy.European radiology · 2021Article
- Conspicuity of malignant pleural mesothelioma in contrast enhanced MDCT - arterial phase or late phase?BMC cancer · 2021Article
- Serum Proteomics and Plasma Fibulin-3 in Differentiation of Mesothelioma From Asbestos-Exposed Controls and Patients With Other Pleural Diseases.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2021Observational
- Diagnostics in Pleural Disease.Diagnostics (Basel, Switzerland) · 2020Review
- Correlation between CT findings and thoracoscopic diagnosis in diffuse pleural disease.Acta bio-medica : Atenei Parmensis · 2020Article
- Early and delayed phases of contrast-enhanced CT for evaluating patients with malignant pleural effusion. Results of pairwise comparison by multiple observers.The British journal of radiology · 2018Article
- Early Contrast Enhancement: A novel magnetic resonance imaging biomarker of pleural malignancy.Lung cancer (Amsterdam, Netherlands) · 2018Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesContrast-enhanced computed tomography (CT) provides essential cross-sectional imaging data in patients with suspected pleural malignancy (PM). The performance of CT in routine practice may be lower than in previously reported research. We assessed this relative to 'real-life' factors including use of early arterial-phase contrast enhancement (by CT pulmonary angiography (CTPA)) and non-specialist radiology reporting. MATERIALS AND
methodsRoutinely acquired and reported CT scans in patients recruited to the DIAPHRAGM study (a prospective, multi-centre observational study of mesothelioma biomarkers) between January 2014 and April 2016 were retrospectively reviewed. CT reports were classified as malignant if they included specific terms e.g. "suspicious of malignancy", "stage M1a" and benign if others were used e.g. "indeterminate", "no cause identified". All patients followed a standard diagnostic algorithm. The diagnostic performance of CT (overall and based on the above factors) was assessed using 2×2 Contingency Tables.
results30/345 (9%) eligible patients were excluded (non-contrast (n=13) or non-contiguous CT (n=4), incomplete follow-up (n=13)). 195/315 (62%) patients studied had PM; 90% were cyto-histologically confirmed. 172/315 (55%) presented as an acute admission, of whom 31/172 (18%) had CTPA. Overall, CT sensitivity was 58% (95% CI 51-65%); specificity was 80% (95% CI 72-87%). Sensitivity of CTPA (performed in 31/315 (10%)) was lower (27% (95% CI 9-53%)) than venous-phase CT (61% (95% CI 53-68%) p=0.0056). Sensitivity of specialist thoracic radiologist reporting was higher (68% (95% CI 55-79%)) than non-specialist reporting (53% (95% CI 44-62%) p=0.0488). Specificity was not significantly different.
conclusionThe diagnostic performance of CT in routine clinical practice is insufficient to exclude or confirm PM. A benign CT report should not dissuade pleural sampling where the presence of primary or secondary pleural malignancy would alter management. Sensitivity is lower with non-thoracic radiology reporting and particularly low using CTPA.
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