CHEST Guidelines-Response_chest

Response_chest_7

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The text discusses the findings and observations related to thoracic ultrasound (TUS) in the diagnosis of malignant pleural mesothelioma (MPM), specifically highlighting its utility in identifying pleural features such as irregular thickening and micronodules, often accompanied by pleural effusion. It mentions that TUS and CT imaging show better concordance in MPM cases due to the tumor's pleural-subpleural location. Fine Needle Aspiration Biopsy (FNAB) under TUS guidance is advantageous over blind or CT-guided biopsies, offering adequate sample quality for pathology assessment. Although CT scanning remains the primary imaging method, the combination of TUS and CT, together with histology, may enhance non-invasive screening for environmental and occupational risks of MPM and lung cancer (LC).<br /><br />The authors discuss the underutilization of thoracic ultrasound in diagnosing pleural diseases, despite growing evidence supporting ultrasound-guided biopsies. They call for consensus on integrating these methods into diagnostic pathways and training programs. Robert J. Hallifax and colleagues thank Dr. Sperandeo for appreciating their work and acknowledge the exciting developments in physician-led ultrasound-guided pleural procedures.<br /><br />All authors affirm no financial or nonfinancial conflicts of interest with relevant companies or organizations. The article is from the American College of Chest Physicians, and reproduction is prohibited without permission. The document references significant studies on ultrasound-guided biopsy for pleural disease and the need for formal guidelines related to the procedure's integration into diagnostic practices. <br /><br />Overall, the text underscores the potential of TUS as a complementary imaging modality that, when combined with CT, could provide a more comprehensive approach to diagnosing and screening pleural and lung conditions.

Keywords

thoracic ultrasound

malignant pleural mesothelioma

pleural effusion

fine needle aspiration biopsy

CT imaging

pleural diseases

ultrasound-guided biopsy

diagnostic pathways

lung cancer screening

American College of Chest Physicians