COMPARATIVE STUDY OF SENSITIVITY BETWEEN THORACOSCOPY AND CT-GUIDED CLOSED PLEURAL BIOPSY FOR UNDIAGNOSED PLEURAL EFFUSION WITH DIFFERENT PLEURAL FEATURES

TYPE: Abstract Publication TOPIC: Procedures PURPOSE: Pleural effusion is one of common respiratory disease. British thoracic society recommends using Abrams needle pleural biopsy under CT scan guidance (CT-ANPB) or thoracoscopy. This study aimed to compare the diagnostic efficiency and reliability of CT-ANPB with that of medical thoracoscopy in patients with undiagnosed pleural effusion and different pleural features. METHODS: Fifty-tree patients with exudative pleural effusion, monocyte predominate that could not be diagnosed by Adenosine deaminase level and cytology were enrolled in the study during January 2015 - 2017. They were classified to high or low probability groups and randomized after the CT scan was performed. Patients were undergone either CT-ANPB or thoracoscopy. The two methods were compared in terms of diagnostic sensitivity and complications. RESULTS: From 53 patients, In the high probability CT-ANPB group, the diagnostic sensitivity was 93.8%, as compared with 100.0% in the thoracoscopy group; the difference was not statistically significant ( P =0.424). On the other hand, among low probability CT-ANPB group, the diagnostic sensitivity was 70.0%, as compared with 100.0% in the thoracoscopy group; the difference was statistically significant ( P= 0.030). No difference was identified between the sensitivities of the two methods in high probability group, but difference was identified in low probability group. Complication rates were low. CONCLUSIONS: In the high probability population ,the diagnostic sensitivity between CT-ANPB and thoracenthesis group were not statistical difference. CLINICAL IMPLICATIONS: Medical thoracoscopy is a preferred method in patients without significant pleural abnormality while among patients with pleural thickening or lesions observed , CT-ANPB and thoracoscropy can be used either. DISCLOSURE: No significant relationships. KEYWORDS: undiagnosed pleural effusion, thoracoscopy, CT-guided pleural biopsy