CHEST Guidelines-Advantages-of-Thoracic-Ultrasound-Guided-Fine-Need

Advantages-of-Thoracic-Ultrasound-Guided-Fine-Need

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In a correspondence to the journal CHEST, Dr. Marco Sperandeo and colleagues emphasize the advantages of using thoracic ultrasound (TUS) and TUS-guided fine-needle aspiration biopsy (FNAB) as primary procedures for diagnosing malignant pleural mesothelioma (MPM) and lung cancer (LC). This method is presented as less traumatic and more successful compared to traditional thoracoscopy, offering minimal patient discomfort and a high diagnostic yield. Their analysis involved 133 patients with MPM and 801 patients with LC who underwent TUS-guided FNAB.<br /><br />The authors argue that TUS, when combined with CT imaging, can effectively detect lesions suitable for biopsy, with reduced complications, such as partial pneumothorax, which were minimal and self-resolving in their study. They suggest that TUS offers finer concordance with CT in MPM cases due to the tumor’s pleural-subpleural positioning. Sperandeo et al. propose TUS as an important complementary imaging tool in non-invasive screening strategies for individuals at environmental and occupational risk for these diseases.<br /><br />In response, Dr. Robert J. Hallifax and colleagues recognize the diagnostic potential of TUS but note that its use is still underrepresented in international guidelines, calling for additional research and consensus to better integrate TUS-guided procedures into respiratory medicine training and diagnostic pathways. Both correspondences highlight the innovative role of physician-led ultrasound technologies in enhancing the diagnostic process for malignant pleural conditions.

Keywords

thoracic ultrasound

fine-needle aspiration biopsy

malignant pleural mesothelioma

lung cancer

diagnostic yield

patient discomfort

CT imaging

pneumothorax

non-invasive screening

ultrasound technologies