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  • Image-assisted Abrams...

Image-assisted Abrams needle biopsy as good as medical thoracoscopy for diagnosis of pleural effusion: Study

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-04-04T04:00:43+05:30  |  Updated On 4 April 2024 10:59 AM IST
Image-assisted Abrams needle biopsy as good as medical thoracoscopy for  diagnosis of pleural effusion: Study
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Researchers have found in a small randomized controlled trial that an initial image-assisted Abrams needle biopsy (IA-ANPB) can match medical thoracoscopy (MT) to diagnose people with pleural effusion.

Image-guided or assisted needle biopsies and the increasing use of medical thoracoscopy (MT) have significantly increased the diagnostic accuracy of pleural diseases. However, there is no consensus on which patients should undergo medical thoracoscopy (MT) and which patient should undergo image-guided or assisted needle biopsy as the first procedure to ensure greater diagnostic accuracy in patients with pleural effusion. This prospective, randomized, parallel study included two hundred twenty-eight patients with undiagnosed exudative pleural effusion. Patients were divided into two groups based on computed tomography (CT) findings. Group 1: patients with pleural effusion only; Group 2: patients with pleural thickening or lesion in addition to pleural effusion. Patients in each group were randomly assigned to an image- assisted Abrams needle biopsy (IA-ANPB) or MT arm. The diagnostic sensitivity, reliability, and safety were determined for both groups.

RESULTS: The false negativity 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%, negative likelihood ratio of 0.30. The same rates for the MT arm were 96.9% and 0.03 (p=0.009). 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=0.207). The rate of complications between the two biopsy methods was not different (8.5% and 15.8%, respectively; p=0.107). MT showed a high diagnostic success in all patients with pleural fluid. On the other hand, IA-ANPB showed similar diagnostic success as MT in patients with pleural effusion and associated pleural thickening/lesions. Therefore, in the latter case, IA-ANPB could be preferable before MT.

Reference:

IMAGE-ASSISTED PLEURAL NEEDLE BIOPSY OR MEDICAL THORACOSCOPY: WHICH METHOD FOR WHICH PATIENT? A RANDOMIZED CONTROLLED TRIAL Muzaffer Metintas, MD Guntulu Ak, MD, PhD Huseyin Yildirim, MD Fusun Alatas, MD Senay Yilmaz, MD Selma Metintas, MD, PhD Show all authors Published:March 28, 2024 DOI:https://doi.org/10.1016/j.chest.2024.03.038


Image-assistedAbrams needle biopsymedical thoracoscopydiagnosispleural effusion
Source : Chest
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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