Supplementary Material for: Additional upfront thoracic ultrasound in the workup of patients with unilateral pleural effusion: A prospective observational pilot study.

Abstract: Background: In patients with pleural effusion, specific ultrasound characteristics are associated with pleural malignancy. Objectives: This study aims to evaluate the added value of an additional, up-front, systematic thoracic ultrasound (TUS) to standard imaging in patients with unilateral pleural effusion of unknown cause in a clinical setting. Methods: In a prospective observational pilot study, patients referred for work-up and thoracentesis of a unilateral pleural effusion received up-front TUS following a set protocol in addition to available imaging and US guiding the thoracentesis or diagnostic puncture. The primary outcome was the proportion of cases where systematic TUS changed the planned diagnostic work-up. Follow-up took place 26 weeks after inclusion. Results: From February to December 2020, 55 patients were included. Thirty-six (65%) patients had other chest imaging available before TUS. Twenty-one (38%) were diagnosed with malignant pleural effusion. Three patients (5%) had clinically relevant changes in the diagnostic work-up after additional systematic TUS. Conclusions: Additional up-front, systematic TUS had limited clinically relevant effect on the planned diagnostic work-up in patients with unilateral pleural effusion in a setting where chest CT scans often are available at referral.

摘要：背景：胸腔积液患者的特定超声特征与胸膜恶性病变相关。目的：本研究旨在评估临床场景中，针对病因不明的单侧胸腔积液患者，先行开展的系统性胸部超声（thoracic ultrasound, TUS）对标准影像学检查的附加价值。方法：本研究为前瞻性观察性预试验，纳入因单侧胸腔积液接受评估与胸腔穿刺术的患者，在现有影像学检查及用于引导胸腔穿刺或诊断性穿刺的超声检查之外，按照既定方案先行系统性TUS检查。主要结局指标为系统性TUS检查后改变既定诊断评估流程的病例占比，随访于患者入组后26周开展。结果：2020年2月至12月，共纳入55例患者。其中36例（65%）患者在接受TUS前已完成其他胸部影像学检查，21例（38%）患者确诊为恶性胸腔积液。额外开展系统性TUS后，共有3例（5%）患者的诊断评估流程出现具有临床意义的调整。结论：在转诊时通常可获取胸部CT扫描的临床场景中，先行开展的系统性TUS检查对单侧胸腔积液患者的既定诊断评估流程仅存在有限的临床相关影响。