Diagnostic accuracy of shear wave elastography in predicting malignant pleural effusions

Background
Chest transthoracic ultrasound is an important tool in diagnosing malignant pleural effusion (MPE). Although ultrasound elastography (UE) has been reported to be useful in diagnosing breast cancers, its value in diagnosing MPE has not been validated. Thus, this study aims to determine the performance of pleural UE in differentiating between MPE and benign pleural effusion.


Patients and methods
One hundred two patients who were suspected of PE underwent transthoracic ultrasound and UE (ShearWave elastography). Receiver operating characteristic curve of elasticity value was used to confirm the diagnostic cut-off value of MPE. Final diagnosis of MPE was confirmed by histocytology and histopathology.


Results
At cut-off value of shear wave elastography (SWE)-max more than or equal to 46.0 and cut-off value of SWE-min more than or equal to 27.2, the diagnostic accuracy of SWE in detecting MPE was 81.8% with sensitivity 100% and specificity 60%. At cut-off value of shear wave velocity (SWV)-mean more than or equal to 2.5 and cut-off value of SWV-max more than or equal to 2.9, SWV can be used as a diagnostic tool in MPE with an accuracy of 81.8%.


Conclusion
SWE is a useful and effective procedure in differentiation between MPE and benign pleural effusion and can become a valuable technique among methods of diagnosis.