Validation of a simple computed tomography scoring system to predict the malignant nature of pleural effusion

• Published in: The Egyptian Journal of Bronchology 2019-12, Vol.13 (5), p.710-715
• Main Authors: Sweed, Rania A., Baess, Ayman I.
• Format: Article
• Language: English
• Subjects: computed tomography scoring system; malignant pleural effusion; Medicine & Public Health; Original Article; Pleural effusion; predictors of malignancy; Tomography
• ISSN: 1687-8426; 2314-8551
• DOI: 10.4103/ejb.ejb_46_19

Objective Weaimed to validate a computed tomography (CT) scoring system and assess its sensitivity and specificity to predict the malignant nature of pleural effusion that is exudative and of undetermined origin. Patients and methods This is a retrospective study that enrolled 123 patients who were referred for medical thoracoscopy in the Chest Department, Alexandria Main University Hospital, between 2013 and 2017 for diagnosing exudative pleural effusion of undetermined origin. CT scans were reviewed by a radiologist who was blinded to the final diagnosis. We applied a scoring system that was generated by Porcel et al. Scoring results were then evaluated using the final diagnosis of thoracoscopic pleural biopsies as the reference. Results The CT score showed a sensitivity and a specificity of 70 and 66.7%, respectively, with an negative predictive value 83% and a positive predictive value 48%, and the area under the receiver operating characteristic curve was 0.745.using a cut-off value of at least 7. Conclusion The CT scoring system could not predict the malignant nature of exudative effusion with great accuracy.