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Hosseini-Nik H, Bayanati H, Souza CA, et al. Limited Chest Ultrasound to Replace CXR in Diagnosis of Pneumothorax Post Image-Guided Transthoracic Interventions. Can Assoc Radiol J. 2021;8465371211034016doi: 10.1177/08465371211034016.
Hosseini-Nik, H., Bayanati, H., Souza, C. A., Gupta, A., McInnes, M. D. F., Pena, E., Revah, G., Seely, J. M., & Dennie, C. (2021). Limited Chest Ultrasound to Replace CXR in Diagnosis of Pneumothorax Post Image-Guided Transthoracic Interventions. Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes, 8465371211034016. https://doi.org/10.1177/08465371211034016
Hosseini-Nik, Hooman, et al. "Limited Chest Ultrasound to Replace CXR in Diagnosis of Pneumothorax Post Image-Guided Transthoracic Interventions." Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes vol. (2021): 8465371211034016. doi: https://doi.org/10.1177/08465371211034016
Hosseini-Nik H, Bayanati H, Souza CA, Gupta A, McInnes MDF, Pena E, Revah G, Seely JM, Dennie C. Limited Chest Ultrasound to Replace CXR in Diagnosis of Pneumothorax Post Image-Guided Transthoracic Interventions. Can Assoc Radiol J. 2021 Aug 10;8465371211034016. doi: 10.1177/08465371211034016. Epub 2021 Aug 10. PMID: 34375546.
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Can Assoc Radiol J. 2021 Aug 10;8465371211034016. doi: 10.1177/08465371211034016. Epub 2021 Aug 10.

Limited Chest Ultrasound to Replace CXR in Diagnosis of Pneumothorax Post Image-Guided Transthoracic Interventions.

Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes

Hooman Hosseini-Nik, Hamid Bayanati, Carolina A Souza, Ashish Gupta, Matthew D F McInnes, Elena Pena, Giselle Revah, Jean M Seely, Carole Dennie

Affiliations

  1. Department of Medical Imaging, 12365The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
  2. Clinical Epidemiology Program, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

PMID: 34375546 DOI: 10.1177/08465371211034016

Abstract

PURPOSE: To assess the diagnostic accuracy of limited chest ultrasound in detecting pneumothorax following percutaneous transthoracic needle interventions using chest X-ray (CXR) as the reference standard.

METHODS: With IRB approval, after providing consent, asymptomatic patients after percutaneous transthoracic needle interventions were enrolled to undergo limited chest ultrasound in addition to CXR. A chest Radiologist blinded to the patient's prior imaging performed a bedside ultrasound, scanning only the first 3 anterior intercostal spaces. Pneumothorax diagnosed on CXR was categorized as small or large and on ultrasound as grades 1, 2, or 3 when detected in 1, 2, or 3 intercostal spaces, respectively.

RESULTS: 38 patients underwent 36 biopsies (34 lungs, 1 pleura, and 1 mediastinum) and 2 coil localizations. CXR showed pneumothorax in 13 patients. Ultrasound was positive in 10 patients, with 9 true-positives, 1 false-positive, 4 false-negatives, and 24 true-negatives. The false positive results were due to apical subpleural bullae. The false-negative results occurred in 2 small apical and 2 focal pneumothoraces at the needle entry sites. Four pneumothoraces were categorized as large on CXR, all of which were categorized as grade 3 on ultrasound. Sensitivity and specificity of US for detection of pneumothorax of any size were 69.23% (95%CI 38.6%, 90.1%) and 96.0% (95%CI 79.6%, 99.9%), and for detection of large pneumothorax were 100% (95%CI 39.8%, 100%) and 100% (95%CI 89.7%, 100%).

CONCLUSIONS: Results of this prospective study is promising. Limited chest ultrasound could potentially replace CXR in the management of postpercutaneous transthoracic needle intervention patients.

Keywords: CT-guided biopsy; chest-X-ray; pneumothorax; ultrasound

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