Is echogenic swirling seen on ultrasound predictive of pleurodesis outcome?
<p><strong>Background:</strong> Echogenic swirling (ES) is commonly seen on ultrasound (US) examination of malignant pleural effusion (MPE) and has been hypothesised to be related to enhanced intrapleural fibrinolytic activity.(1) Pleurodesis is commonly offered to MPE patients. Pr...
| Main Authors: | , , , , , , |
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| Format: | Conference item |
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European Respiratory Society
2018
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| _version_ | 1797099626172514304 |
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| author | Hassan, M Mercer, R Asciak, R Russel, N Hallifax, R Wrightson, J Rahman, N |
| author_facet | Hassan, M Mercer, R Asciak, R Russel, N Hallifax, R Wrightson, J Rahman, N |
| author_sort | Hassan, M |
| collection | OXFORD |
| description | <p><strong>Background:</strong> Echogenic swirling (ES) is commonly seen on ultrasound (US) examination of malignant pleural effusion (MPE) and has been hypothesised to be related to enhanced intrapleural fibrinolytic activity.(1) Pleurodesis is commonly offered to MPE patients. Previous markers studied for prediction of pleurodesis outcome (e.g. glucose, pH) were not found to be robust. This study aimed to investigate if ES is associated with effusion recurrence.</p> <p><strong>Methods:</strong> Patients with MPE, who had pleurodesis at our unit between 2016-2017 and had assessable US videos or images were included. Cases with non-expandable lung following fluid evacuation were excluded. Pleurodesis failure was defined as fluid recurrence on one month X-ray or need for further interventions in 3 months.</p> <p><strong>Results:</strong> 37 cases met inclusion criteria. The primary cancer was mesothelioma in 18 patients, breast in 7 and lung in 6. Failure rate of pleurodesis was 48%. ES was seen in 14/18 cases with failed pleurodesis, while it was seen in 5/19 cases with successful pleurodesis (Chi square 9.7, p value 0.003). There was no significant difference in fluid protein level (median (IQR) of 46 (42-48) g/L in success group vs 40 (35-44) g/L in failure group) or LDH level (median (IQR) 270 (182-432) IU/L in success group vs 188 (99-940) IU/L in failure group). No significant difference in pleurodesis outcome was noted according to the primary tumour.</p> <p><strong>Conclusion:</strong> ES seems to be associated with a higher rate of pleurodesis failure in patients with MPE. This needs to be validated in prospective fashion in a larger patient cohort and to be correlated to other variables such as cytological positivity and degree of pleural thickening.</p> |
| first_indexed | 2024-03-07T05:26:21Z |
| format | Conference item |
| id | oxford-uuid:e0b3afae-5c5e-4172-bf43-66005bcdecd1 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T05:26:21Z |
| publishDate | 2018 |
| publisher | European Respiratory Society |
| record_format | dspace |
| spelling | oxford-uuid:e0b3afae-5c5e-4172-bf43-66005bcdecd12022-03-27T09:49:08ZIs echogenic swirling seen on ultrasound predictive of pleurodesis outcome?Conference itemhttp://purl.org/coar/resource_type/c_5794uuid:e0b3afae-5c5e-4172-bf43-66005bcdecd1Symplectic Elements at OxfordEuropean Respiratory Society2018Hassan, MMercer, RAsciak, RRussel, NHallifax, RWrightson, JRahman, N<p><strong>Background:</strong> Echogenic swirling (ES) is commonly seen on ultrasound (US) examination of malignant pleural effusion (MPE) and has been hypothesised to be related to enhanced intrapleural fibrinolytic activity.(1) Pleurodesis is commonly offered to MPE patients. Previous markers studied for prediction of pleurodesis outcome (e.g. glucose, pH) were not found to be robust. This study aimed to investigate if ES is associated with effusion recurrence.</p> <p><strong>Methods:</strong> Patients with MPE, who had pleurodesis at our unit between 2016-2017 and had assessable US videos or images were included. Cases with non-expandable lung following fluid evacuation were excluded. Pleurodesis failure was defined as fluid recurrence on one month X-ray or need for further interventions in 3 months.</p> <p><strong>Results:</strong> 37 cases met inclusion criteria. The primary cancer was mesothelioma in 18 patients, breast in 7 and lung in 6. Failure rate of pleurodesis was 48%. ES was seen in 14/18 cases with failed pleurodesis, while it was seen in 5/19 cases with successful pleurodesis (Chi square 9.7, p value 0.003). There was no significant difference in fluid protein level (median (IQR) of 46 (42-48) g/L in success group vs 40 (35-44) g/L in failure group) or LDH level (median (IQR) 270 (182-432) IU/L in success group vs 188 (99-940) IU/L in failure group). No significant difference in pleurodesis outcome was noted according to the primary tumour.</p> <p><strong>Conclusion:</strong> ES seems to be associated with a higher rate of pleurodesis failure in patients with MPE. This needs to be validated in prospective fashion in a larger patient cohort and to be correlated to other variables such as cytological positivity and degree of pleural thickening.</p> |
| spellingShingle | Hassan, M Mercer, R Asciak, R Russel, N Hallifax, R Wrightson, J Rahman, N Is echogenic swirling seen on ultrasound predictive of pleurodesis outcome? |
| title | Is echogenic swirling seen on ultrasound predictive of pleurodesis outcome? |
| title_full | Is echogenic swirling seen on ultrasound predictive of pleurodesis outcome? |
| title_fullStr | Is echogenic swirling seen on ultrasound predictive of pleurodesis outcome? |
| title_full_unstemmed | Is echogenic swirling seen on ultrasound predictive of pleurodesis outcome? |
| title_short | Is echogenic swirling seen on ultrasound predictive of pleurodesis outcome? |
| title_sort | is echogenic swirling seen on ultrasound predictive of pleurodesis outcome |
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