Thoracic ultrasound as an early predictor of pleurodesis success in malignant pleural effusion
<strong>BACKGROUND</strong>: Malignant pleural effusion (MPE) is common and imposes a significant burden on patients and health-care providers. Most patients require definitive treatment, usually drainage and chemical pleurodesis, to relieve symptoms and prevent fluid recurrence. Thoraci...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2018
|
| _version_ | 1797071269481414656 |
|---|---|
| author | Corcoran, J Hallifax, R Mercer, R Yousuf, A Asciak, R Hassan, M Piotrowska, H Psallidas, I Rahman, N |
| author_facet | Corcoran, J Hallifax, R Mercer, R Yousuf, A Asciak, R Hassan, M Piotrowska, H Psallidas, I Rahman, N |
| author_sort | Corcoran, J |
| collection | OXFORD |
| description | <strong>BACKGROUND</strong>: Malignant pleural effusion (MPE) is common and imposes a significant burden on patients and health-care providers. Most patients require definitive treatment, usually drainage and chemical pleurodesis, to relieve symptoms and prevent fluid recurrence. Thoracic ultrasound (TUS) can identify the presence of pleural adhesions in other clinical scenarios, and could therefore have a role in predicting long-term pleurodesis success or failure in MPE. <strong>METHODS</strong>: Patients undergoing chest tube drainage and talc slurry pleurodesis for symptomatic MPE were recruited to a prospective observational cohort pilot study assessing whether TUS findings pre-talc and post-talc instillation predicted treatment outcome. Participants underwent TUS examination immediately before, and 24 h after talc slurry administration to derive pleural adherence scores for the affected hemithorax. The recorded TUS scans were additionally scored by two independent assessors blinded to the patient’s clinical status. The primary outcome was pleurodesis success at 1-month and 3-month follow-up. <strong>RESULTS</strong>: Eighteen participants were recruited to the pilot study. Participants who suffered pleurodesis failure had a lower pleural adherence score at 24 h post-talc instillation than those who were successful (difference of 6.27; 95% CI, 3.94-8.59). TUS examination was acceptable to patients, while TUS scoring was highly consistent across all assessors (intraclass correlation coefficient, 0.762; 95% CI, 0.605-0.872). <strong>CONCLUSION</strong>: A TUS-derived pleural adherence score may facilitate early prediction of longterm outcomes following chemical pleurodesis, with implications for personalized care and decision making in MPE. Further research is needed to evaluate this novel finding. |
| first_indexed | 2024-03-06T22:50:52Z |
| format | Journal article |
| id | oxford-uuid:5eb99d3c-e013-455e-af83-12d5e31083bd |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:50:52Z |
| publishDate | 2018 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:5eb99d3c-e013-455e-af83-12d5e31083bd2022-03-26T17:42:29ZThoracic ultrasound as an early predictor of pleurodesis success in malignant pleural effusionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5eb99d3c-e013-455e-af83-12d5e31083bdEnglishSymplectic Elements at OxfordElsevier2018Corcoran, JHallifax, RMercer, RYousuf, AAsciak, RHassan, MPiotrowska, HPsallidas, IRahman, N<strong>BACKGROUND</strong>: Malignant pleural effusion (MPE) is common and imposes a significant burden on patients and health-care providers. Most patients require definitive treatment, usually drainage and chemical pleurodesis, to relieve symptoms and prevent fluid recurrence. Thoracic ultrasound (TUS) can identify the presence of pleural adhesions in other clinical scenarios, and could therefore have a role in predicting long-term pleurodesis success or failure in MPE. <strong>METHODS</strong>: Patients undergoing chest tube drainage and talc slurry pleurodesis for symptomatic MPE were recruited to a prospective observational cohort pilot study assessing whether TUS findings pre-talc and post-talc instillation predicted treatment outcome. Participants underwent TUS examination immediately before, and 24 h after talc slurry administration to derive pleural adherence scores for the affected hemithorax. The recorded TUS scans were additionally scored by two independent assessors blinded to the patient’s clinical status. The primary outcome was pleurodesis success at 1-month and 3-month follow-up. <strong>RESULTS</strong>: Eighteen participants were recruited to the pilot study. Participants who suffered pleurodesis failure had a lower pleural adherence score at 24 h post-talc instillation than those who were successful (difference of 6.27; 95% CI, 3.94-8.59). TUS examination was acceptable to patients, while TUS scoring was highly consistent across all assessors (intraclass correlation coefficient, 0.762; 95% CI, 0.605-0.872). <strong>CONCLUSION</strong>: A TUS-derived pleural adherence score may facilitate early prediction of longterm outcomes following chemical pleurodesis, with implications for personalized care and decision making in MPE. Further research is needed to evaluate this novel finding. |
| spellingShingle | Corcoran, J Hallifax, R Mercer, R Yousuf, A Asciak, R Hassan, M Piotrowska, H Psallidas, I Rahman, N Thoracic ultrasound as an early predictor of pleurodesis success in malignant pleural effusion |
| title | Thoracic ultrasound as an early predictor of pleurodesis success in malignant pleural effusion |
| title_full | Thoracic ultrasound as an early predictor of pleurodesis success in malignant pleural effusion |
| title_fullStr | Thoracic ultrasound as an early predictor of pleurodesis success in malignant pleural effusion |
| title_full_unstemmed | Thoracic ultrasound as an early predictor of pleurodesis success in malignant pleural effusion |
| title_short | Thoracic ultrasound as an early predictor of pleurodesis success in malignant pleural effusion |
| title_sort | thoracic ultrasound as an early predictor of pleurodesis success in malignant pleural effusion |
| work_keys_str_mv | AT corcoranj thoracicultrasoundasanearlypredictorofpleurodesissuccessinmalignantpleuraleffusion AT hallifaxr thoracicultrasoundasanearlypredictorofpleurodesissuccessinmalignantpleuraleffusion AT mercerr thoracicultrasoundasanearlypredictorofpleurodesissuccessinmalignantpleuraleffusion AT yousufa thoracicultrasoundasanearlypredictorofpleurodesissuccessinmalignantpleuraleffusion AT asciakr thoracicultrasoundasanearlypredictorofpleurodesissuccessinmalignantpleuraleffusion AT hassanm thoracicultrasoundasanearlypredictorofpleurodesissuccessinmalignantpleuraleffusion AT piotrowskah thoracicultrasoundasanearlypredictorofpleurodesissuccessinmalignantpleuraleffusion AT psallidasi thoracicultrasoundasanearlypredictorofpleurodesissuccessinmalignantpleuraleffusion AT rahmann thoracicultrasoundasanearlypredictorofpleurodesissuccessinmalignantpleuraleffusion |